Selected characteristics and injury patterns by age group among pedestrians treated in North Carolina emergency departments

Abstract

Objective: The objective of this study was to describe pedestrian demographic characteristics, crash characteristics, selected health outcomes, and injury patterns by age using linked North Carolina (NC) crash-emergency department (ED) visit data for the period October 1, 2010, to September 30, 2015.

Methods: This was a descriptive epidemiologic study. To examine both crash and health outcomes, NC pedestrian crash records were linked to statewide NC ED visit records using hierarchical deterministic methods. Pearson chi-square tests were used to compare the frequencies of pedestrians treated in NC EDs by sex, race/ethnicity, crash location, rurality, estimated driver speed at impact, ambient light, hospitalization/death, location of injury, and nature of injury, stratified by the following age groups: 0-14, 15-24, 25-64, and ≥65 years.

Results: Most pedestrians treated in NC EDs were male (57.5%), except among adults ≥65 years old (47.5%). Over half of all injured pedestrians aged 0-14 (52.6%) and 15-24 (50.5%) years were Black/African American, and 70.8% of injured pedestrians ≥65 years were white. Among pedestrians aged 25-64 years, no single racial/ethnic group was the majority. Though most pedestrians were injured on trafficways (71.7%) and at speeds ≤35 mph (80.1%), adults ≥65 years were less likely to be involved in on-trafficway crashes (51.0%) and pedestrians aged 15-24 years were more likely to be involved in >35 mph crashes (22.9%) compared to other age groups. Most pedestrians were injured under daylight conditions (56.9%). Regarding selected health outcomes, the highest frequency of hospitalization/death was for pedestrians aged ≥65 years (26.3%), compared to those aged 0-14 years (18.8%) and 15-64 years (12.4%). In terms of location of injury, 0- to 14-year-olds had the highest proportion of head injuries (39.5%), and adults ≥65 years of age had the highest proportion of spinal column/vertebral column (12.6%) and upper extremity injuries (33.2%). For nature of injury, 0- to 14-year-olds had the highest proportion of traumatic brain injuries (11.4%) and superficial wounds and contusions (62.8%). Adults aged ≥65 years had the highest proportion of open wounds/amputations and fractures (16.1%). Adults aged 25-64 years had the highest proportion of strains/sprains/dislocations (18.7%).

Conclusions: There were considerable differences in demographic characteristics, crash characteristics, frequency of hospitalization/death, and injury patterns by age group. It is important to design streets and implement transportation policies and programs that improve safety for all pedestrians.

Keywords: Pedestrian; emergency department; injury severity.