Assessing the Cushion Effect: A Systematic Review and Meta-Analysis of the Role of Obesity in Motor Vehicle Injuries and Fatalities

Purpose: A systematic review and meta-analysis were done to evaluate the effect of obesity in injury and mortality due to motor vehicle accidents. Materials & Methods: The systematic review consisted of 20 studies meeting the inclusion criteria. The meta-analysis was conducted on these studies to analyze obesity as a risk factor for specific injuries, as well as overall injury and mortality compared to non-obese patients. Results: The data revealed that obesity was associated with increased lower extremity injuries (odds ratio [OR] = 1.44, 95% confidence interval [CI] = 1.19-1.69, P ≤ 0.05), neck injuries (OR = 3.38, 95% CI = 1.58-5.19, P ≤ 0.05), and overall mortality (OR = 1.51, 95% CI = 1.40-1.61, P ≤ 0.05). When stratified for obesity class with class I as BMI >30.1-34.9, class II BMI 35-39.9, and class III BMI >40, only class II (OR = 1.20, 95% CI = 1.15-1.24, P ≤ 0.05) and class III (OR = 1.49, 95% CI = 1.30-1.68, P ≤ 0.05) were associated with increased mortality risk. No significant differences were seen with head, upper extremity, thoracic, abdominal, or pelvic injuries. Conclusion: Obesity is a risk factor in motor vehicle accidents for fatality and injury, specifically lower extremity and neck injuries.

Download Full-text

Faculty Opinions recommendation of Risk of Motor Vehicle Accidents Related to Sleepiness at the Wheel: A Systematic Review and Meta-Analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.732012359.793540147 ◽

2017 ◽

Author(s):

Maria Bonsignore

Keyword(s):

Systematic Review ◽

Motor Vehicle ◽

Meta Analysis ◽

Motor Vehicle Accidents ◽

Vehicle Accidents

Download Full-text

The relationship between weight indices and injuries and mortalities caused by the motor vehicle accidents: a systematic review and meta-analysis

Journal of Injury and Violence Research ◽

10.5249/jivr.v12i1.1198 ◽

2019 ◽

Vol 12 (1) ◽

Keyword(s):

Systematic Review ◽

Motor Vehicle ◽

Meta Analysis ◽

Motor Vehicle Accidents ◽

Vehicle Accidents ◽

The Relationship

Download Full-text

Risk of Motor Vehicle Accidents Related to Sleepiness at the Wheel: A Systematic Review and Meta-Analysis

SLEEP ◽

10.1093/sleep/zsx134 ◽

2017 ◽

Vol 40 (10) ◽

Cited By ~ 51

Author(s):

Stéphanie Bioulac ◽

Jean-Arthur Micoulaud-Franchi ◽

Mickael Arnaud ◽

Patricia Sagaspe ◽

Nicholas Moore ◽

...

Keyword(s):

Systematic Review ◽

Motor Vehicle ◽

Meta Analysis ◽

Motor Vehicle Accidents ◽

Vehicle Accidents

Download Full-text

Risk of Motor Vehicle Accidents Related to Sleepiness at the Wheel: A Systematic Review and Meta-Analysis

SLEEP ◽

10.1093/sleep/zsy075 ◽

2018 ◽

Vol 41 (7) ◽

Cited By ~ 4

Author(s):

Stéphanie Bioulac ◽

Jean-Arthur Micoulaud-Franchi ◽

Mickael Arnaud ◽

Patricia Sagaspe ◽

Nicholas Moore ◽

...

Keyword(s):

Systematic Review ◽

Motor Vehicle ◽

Meta Analysis ◽

Motor Vehicle Accidents ◽

Vehicle Accidents

Download Full-text

The Role of Obesity in Motor Vehicle Injuries and Fatalities in the Pediatric Population: A Systematic Review

Journal of Intensive Care Medicine ◽

10.1177/0885066621992738 ◽

2021 ◽

pp. 088506662199273

Author(s):

Zana Alattar ◽

Shelby Hoebee ◽

Eyal Ron ◽

Paul Kang ◽

Eric vanSonnenberg

Keyword(s):

Systematic Review ◽

Risk Factor ◽

Motor Vehicle ◽

Pediatric Population ◽

Extremity Injury ◽

Obese Children ◽

Patients Âgés ◽

Vehicle Accidents ◽

Increased Risk ◽

Extremity Injuries

Purpose: A systematic review done to evaluate obesity as a risk factor for injuries and mortality in motor vehicle accidents (MVAs) in the pediatric population, as there has not been a systematic review done in over 10 years. This study aims to update the literature regarding obesity as a risk factor for injuries in MVAs in the pediatric population. Materials and Methods: A systematic review was conducted according to the PRISMA guidelines with strict inclusion and exclusion criteria, resulting in the use of 3 total articles to analyze obesity as a risk factor for overall injury and mortality in the pediatric population. Results: Zaveri et al demonstrated a statistically significant, but weak, decrease in the odds of extremity injury in overweight patients ages 2 to 17 years old (odds ratio [OR] = 0.6, 95% confidence interval [CI] = 0.4-1.0, P ≤ 0.05). On the other hand, Pollack et al and Haricharan et al found an increase in extremity injury in the obese population, in ages 9 to 15 years (OR = 2.54, 95% CI = 1.15-5.59, P ≤ 0.05), and 10 to 17 years (Age 10-13: OR = 6.06, 95% CI = 2.23-16.44, P ≤ 0.05, Age 14-17 OR = 1.44, 95% CI = 1.04-2.00, P ≤ 0.05), respectively. Haricharan et al also found an increase in thoracic injuries in obese children, ages 2 to 13 and increased risk of head/face/neck injury in obese children ages 2 to 5 (OR = 3.67, 95% CI = 1.03-13.08, P ≤ 0.05), but a decreased risk of head injury in obese children ages 14 to 17 (OR = 0.33, 95% CI = 0.18-0.60, P ≤ 0.05). Conclusions: There are sparse data that are conflicting, regarding the effect of obesity on extremity injuries in the pediatric population. Obesity is not protective against thoracic, head, or abdominal injuries. However, it was found to be a risk factor for trunk injuries in ages 2 to 13, as well as head/face/neck injuries for ages 2 to 5. Since the literature is so sparse, further research is warranted in these areas.

Download Full-text

Low-Energy Multiligament Knee Injuries Are Associated With Higher Postoperative Activity Scores Compared With High-Energy Multiligament Knee Injuries: A Systematic Review and Meta-analysis of the Literature

The American Journal of Sports Medicine ◽

10.1177/0363546520962088 ◽

2020 ◽

pp. 036354652096208

Author(s):

Robert S. Dean ◽

Nicholas N. DePhillipo ◽

David H. Kahat ◽

Nathan R. Graden ◽

Christopher M. Larson ◽

...

Keyword(s):

Systematic Review ◽

Motor Vehicle ◽

Meta Analysis ◽

Knee Injuries ◽

High Energy ◽

Low Energy ◽

Vehicle Accidents ◽

Injury Mechanisms ◽

Outcome Scores ◽

Multiligament Knee Injuries

Background: Multiligament knee injuries (MLKIs) can result from high-energy injury mechanisms such as motor vehicle accidents or low-energy injury mechanisms such as activities of daily living or sports. Purpose/Hypothesis: The purpose was to conduct a systematic review on postoperative patient-reported outcomes after MLKIs and to conduct a meta-analysis of comparable outcome variables based upon high- versus low-energy injury mechanisms. It was hypothesized that MLKIs with low-energy injury mechanisms would demonstrate significantly improved subjective clinical outcome scores compared with high-energy injuries. Study design: Meta-analysis and systematic review. Methods: A systematic review was performed with the inclusion criteria of postoperative MLKI outcomes based upon high-versus low-energy mechanisms of injury with a minimum 2-year follow-up. Outcome scores included were the Lysholm knee scoring scale, Tegner activity scale, and the International Knee Documentation Committee (IKDC) score. High-energy mechanisms included motor vehicle accidents or falls from a height >5 feet; low-energy mechanisms included sports-related injuries, activities of daily living, or falls from <5 feet. A meta-analysis was performed comparing the outcome scores of high- versus low-energy mechanisms of MLKIs. Results: Overall, 1214 studies were identified, 15 of which were included in the systematic review and meta-analysis. Thirteen studies included surgical reconstructions of all injured ligaments. A total of 641 patients with 275 high-energy and 366 low-energy injuries were grouped for comparison in the meta-analysis. No significant differences in Lysholm scale (78.6 vs 78.0) or IKDC scores (69.0 vs 68.4) were found between high- and low-energy groups at a minimum of 2 years (range, 2-10 years) postoperatively ( P > .05). The low-energy injury group demonstrated significantly higher Tegner activity scale scores (5.0 vs 3.9; P = .03). There was no significant difference in failure rates between groups (3.5% vs 2.0%; P = .23). Conclusion: We found in this systematic review and meta-analysis that patients with low-energy mechanisms of MLKI surgery had improved postoperative Tegner activity scores compared with those patients with high-energy mechanisms after MLKI surgery. However, there were no differences in Lysholm score, IKDC score, or failure rates between high- and low-energy MLKI patients at an average of 5.3 years postoperatively.

Download Full-text