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Observational Study
. 2018 Sep;97(38):e12350.
doi: 10.1097/MD.0000000000012350.

Motor vehicle accident mortality by elderly drivers in the super-aging era: A nationwide hospital-based registry in Japan

Tasuku Matsuyama  1 , Tetsuhisa Kitamura, Yusuke Katayama, Tomoya Hirose, Takeyuki Kiguchi, Junya Sado, Kosuke Kiyohara, Junichi Izawa, Nobunaga Okada, Kotaro Takebe, Makoto Watanabe, Yuki Miyamoto, Yoshihiro Yamahata, Bon Ohta
Affiliations
Observational Study

Motor vehicle accident mortality by elderly drivers in the super-aging era: A nationwide hospital-based registry in Japan

Tasuku Matsuyama et al. Medicine (Baltimore). 2018 Sep.

Abstract

Motor vehicle accidents (MVAs) are one of the major public health burdens worldwide. In particular, MVAs by elderly drivers have been significantly increasing in recent years in industrialized countries. This study aimed to assess the MVA characteristics and outcomes caused by elderly drivers in Japan.Japan Trauma Data Bank (JTDB) is a prospective, nationwide, hospital-based registry for trauma patients from 256 institutions in Japan. This study enrolled all MVA drivers older than the legal age for driving between 2004 and 2015. The included patients were divided into the following 3 groups: adults (aged ≤64 years), young-old (aged 65-74 years), and old-old (aged ≥75 years). The primary outcome was in-hospital mortality. The trend in the proportion of MVAs caused by the young-old or the old-old group was evaluated using the Cochran-Armitage trend test. To assess the association of the old-old group with in-hospital mortality, compared with the adult group, we used multivariable logistic regression analysis.During the study period, a total of 236,698 trauma patients were registered, and 39,691 patients (16.8%) were eligible for our analysis. The proportion of MVAs caused by elderly drivers aged ≥65 years significantly increased from 11.7% in 2004 to 23.8% in 2015 (P < .001). As for the primary outcome, unadjusted in-hospital mortality increased with age, but decreased year-by-year irrespective of the age group. In multivariable logistic regression analysis, in-hospital mortality was significantly higher in the old-old group than in the adult group [17.3% (584/3372) vs 8.0% (2556/31,985); adjusted odds ratio 4.80; 95% confidence interval 4.06-5.67].In the super-aging society of Japan, the proportion of MVAs by elderly drivers increased year-by-year, and the mortality rate was highest in those aged above 75 years.

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Figures

Figure 1
Figure 1
Flowchart of patient enrolment. JTDB = Japan Trauma Data Bank.
Figure 2
Figure 2
Prevalence of motor vehicle accidents caused by elderly drivers during the study period.
Figure 3
Figure 3
Probability of in-hospital death by patient's age per 4-year strata.
See this image and copyright information in PMC

References

    1. World Health Organization. Violence and Injury Prevention. Road Traffic Injuries. Available at: http://www.who.int/violence_injury_prevention/road_traffic/en/. Accessed December 10, 2017.
    1. Ministry of Land, Infrastructure, Transport and Tourism. Road Bureau. Safety. Available at: http://www.mlit.go.jp/road/road/traffic/sesaku/index.html. Accessed December 10, 2017.
    1. National Police Agency. Survey of Driver's License. Available at: https://www.npa.go.jp/toukei/menkyo/index.htm. Accessed December 12, 2017.
    1. Center for Disease Control and Prevention. Motor Vehicle Safety. Older Adult Drivers. Available at: https://www.cdc.gov/motorvehiclesafety/older_adult_drivers/index.html. Accessed December 10, 2017.
    1. European Commission. Mobility and Transport. Road Safety. Available at: https://ec.europa.eu/transport/road_safety/home_en. Accessed December 10, 2017.

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