BACKGROUND: Although rates of fatal injuries related to motor vehicle-traffic have declined over time, rates of fatal injuries among pedestrians have not declined. Pedestrians are at risk for severe injuries due to motor vehicle crashes; prevention of these injuries would result in substantial decreases in morbidity, mortality, and associated healthcare costs. Using a linked dataset including crash data and trauma registry data, we analyzed differences in crash factors and injury outcomes between pedestrians and other primary roles involved in motor vehicle crashes.
METHODS: We conducted probabilistic linking between Texas Department of Transportation crash data and Texas trauma registry data for 2014 using Link Plus software. Using the crash role variable, we compared pedestrians to all other primary roles (i.e., motor vehicle driver/occupant, pedal cyclist, motorcyclist, other/unknown) in regards to demographics, crash factors, and injury outcomes. Using SAS 9.4 software, we calculated descriptive statistics including counts and proportions. We also did chi-square testing to determine whether there were differences in demographics, crash factors, and injury outcomes based on crash role.
RESULTS: About 11% (N=1,316) of the individuals in the linked dataset (N=11,886) were pedestrians; other roles included motor vehicle drivers and occupants (68%), motorcyclists (18%), and pedal cyclists (3%). Pedestrians were less likely to be males compared to all other roles (64% vs. 69%, p<0.0001) and more likely to be younger, which was expected since the linkage was based on primary crash roles – very few motor vehicle occupants were included in this dataset. Pedestrians were also more likely to be black non-Hispanic or Hispanic compared to all other roles (54% vs. 38%, p<0.001). Crashes involving pedestrians were much more likely to occur in non-rural locations (86% vs. 59% for all other roles). Compared to other roles, pedestrians were significantly more likely to have high injury severity scores (25-75) and long lengths of stay (4 days or more). Nearly one in four pedestrians had a primary injury diagnosis for traumatic brain injury (23% vs. 16% for all other roles, p<0.001).
CONCLUSIONS: Pedestrians are at particular risk for severe injuries related to motor vehicle crashes, many of which are traumatic brain injuries. Linked data allow for analyses that describe which crash factors and injury outcomes are associated with certain crash roles. Prevention of pedestrian-related injuries requires approaches that both minimize likelihood of crashes and decrease severity of crashes that do occur.