What question did this study set out to answer?

This research aims to analyze sex-specific differences in thoracic injury prevalence and causative factors among occupants involved in frontal motor vehicle collisions.

May 9, 2026

Comparative Analysis of Thoracic Injury and Causative Factors across Sexes in Serious Frontal Motor Vehicle Collisions in the Crash Injury Research and Engineering Network Database

Key Points

This research aims to analyze sex-specific differences in thoracic injury prevalence and causative factors among occupants involved in frontal motor vehicle collisions.
Utilized CIREN data from 2005 to 2022, including 793 front-seat occupants with AIS 2+ thoracic injuries.
Injuries categorized into rib fractures, sternum fractures, hemo/pneumothoraces, lung injuries, heart injuries, and other.
Employed logistic and linear regression with generalized estimating equations to assess sex associations.
Females were less likely to sustain lung injuries (OR = 0.70, p = 0.038) and more likely to have rib fractures (OR = 1.25, p = 0.006).
Females exhibited higher odds of rib fractures due to seatbelt loading (Full model: OR = 2.20, p = 0.005; Simplified model: OR = 1.55, p = 0.021).
No significant associations between sex and other components like steering wheel or airbag injuries were found.

Abstract

This study investigated sex-specific differences in thoracic injury prevalence, causation, and rib fracture patterns among seriously injured occupants in frontal motor vehicle collisions. Crash Injury Research and Engineering Network (CIREN) data from 2005 to 2022 included 793 front-seat occupants aged 16 years and older with Abbreviated Injury Scale 2+ thorax injury, representing 1802 thoracic injuries. Injuries were grouped as rib fracture, sternum fracture, hemo/pneumothorax, lung injury, heart injury, and other. A weighted scoring system captured contributions of involved physical components to each injury. Logistic and linear regression with generalized estimating equations assessed sex associations with injury presence and causation. Two models were estimated: a comprehensively adjusted model including demographic, crash, vehicle, restraint, and airbag deployment, and a simplified model adjusting for age, body mass index, delta-V, and occupant role. Among occupants with AIS 2+ thoracic injuries, sex-specific differences were observed in injury patterns and causation. Females were less likely than males to sustain lung injuries (OR = 0.70, p = 0.038) and more likely to sustain rib fractures (OR = 1.25, p = 0.006). Females had higher odds of rib fractures attributed to seatbelt loading in both models (Full: OR = 2.20, p = 0.005; Simplified: OR = 1.55, p = 0.021). Females were less likely than males to sustain lung injuries (OR = 0.17, p = 0.042) and hemo/pneumothoraces (OR = 0.15, p = 0.044) from instrument panel loading. Steering wheel, airbag, and other components showed no significant sex-specific associations with thoracic injury. Rib fracture patterns showed clusters along the seatbelt path in belted occupants and a more diffuse pattern in unbelted occupants, with minimal significant findings of differences between sexes. These findings contribute to the growing evidence of sex-specific injury patterns and may inform future research on injury prediction and prevention strategies. However, this dataset includes only occupants with AIS 2+ thoracic injuries and therefore cannot be extrapolated to the general population or to collisions outside those represented in the sample.

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