Rear seating position is associated with a higher risk of mortality in motor vehicle crashes: analysis of Japanese Trauma Data Bank

AIM: The study examined the association of vehicle seating positions with the risk of death in serious motor vehicle crashes (MVCs) in Japan. METHODS: = 23,040). The cases were divided into three groups based on their seating position during the crash: the driver seat, front passenger seat, and rear passenger seats. The primary outcome variable was in-hospital mortality. Multivariable logistic regression analysis was used to assess the association between the seating position and in-hospital mortality. Potential factors associated with each seating position and in-hospital mortality were also assessed. RESULTS: The odds ratios (ORs) for deaths were estimated for front and rear passengers compared to those for the driver in MVCs. The adjusted ORs (95% confidence interval [CI]) for death were 0.96 (0.84-1.11) and 1.22 (1.04-1.42) for front and rear passengers, respectively. Factors significantly associated with MVC deaths were age over 71 years (OR = 3.38; 95% CI, 2.58-4.41), male gender (OR = 1.54; 95% CI, 1.39-1.71), and night driving (OR = 1.17; 95% CI, 1.06-1.29). CONCLUSIONS: This hospital-based study suggested that rear seating increased the risk of MVC-related death. Further studies are needed in order to find mechanisms of the increase in mortality by the seating position.