Does a “Cushion Effect” Really Exist? A Morphomic Analysis of Vulnerable Road Users with Serious Blunt Abdominal Injury
<i>Introduction:</i> The severity of injury from motor vehicle crashes (MVCs) depends on complex biomechanical factors, and the bodily features of the injured person account for some of these factors. By assuming that vulnerable road users (VRUs) have limited protection resulting from ve...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/9/8/1006 |
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| author | Yu-San Tee Chi-Tung Cheng Chi-Hsun Hsieh Shih-Ching Kang Chih-Yuan Fu Brian A. Derstine Grace L. Su Stewart C. Wang |
| author_facet | Yu-San Tee Chi-Tung Cheng Chi-Hsun Hsieh Shih-Ching Kang Chih-Yuan Fu Brian A. Derstine Grace L. Su Stewart C. Wang |
| author_sort | Yu-San Tee |
| collection | DOAJ |
| description | <i>Introduction:</i> The severity of injury from motor vehicle crashes (MVCs) depends on complex biomechanical factors, and the bodily features of the injured person account for some of these factors. By assuming that vulnerable road users (VRUs) have limited protection resulting from vehicles and safety equipment, the current study analyzed the characteristics of fat distribution measured by computed tomography (CT) imaging and investigated the existence of a “cushion effect” in VRUs. <i>Materials and Methods:</i> This retrospective study enrolled 592 VRUs involved in MVCs who underwent CT scans. Visceral fat area and subcutaneous fat cross-sectional area were measured and adjusted according to total body area (TBA) and are presented as the visceral fat ratio and the subQ fat ratio (subcutaneous fat ratio). Risk factors for serious abdominal injury (maximum abbreviated injury scale (MAIS<sub>abd</sub> ≥ 3)) resulting from MVCs were determined by univariate and multivariate analysis. <i>Results:</i> MAIS<sub>abd</sub> ≥ 3 was observed in 104 (17.6%) of the patients. The subQ fat ratio at the L4 vertebral level was significantly lower in the MAIS<sub>abd</sub> ≥ 3 group than in the MAIS<sub>abd</sub> < 3 group (24.9 ± 12.0 vs. 28.1 ± 11.9%; <i>p</i> = 0.015). A decreased L4 subQ fat ratio was associated with a higher risk for MAIS<sub>abd</sub> ≥ 3 in multivariate analysis (odds ratio 0.063; 95% CI 0.008–0.509; <i>p</i> = 0.009). <i>Conclusion:</i> The current study supported the “cushion effect” theory, and protection was apparently provided by subcutaneous fat tissue. This concept may further improve vehicle and safety designation in the future. |
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| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-10T08:46:42Z |
| publishDate | 2021-08-01 |
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| series | Healthcare |
| spelling | doaj.art-4773f4a52281460580bdc7de30eddd8c2023-11-22T07:49:30ZengMDPI AGHealthcare2227-90322021-08-0198100610.3390/healthcare9081006Does a “Cushion Effect” Really Exist? A Morphomic Analysis of Vulnerable Road Users with Serious Blunt Abdominal InjuryYu-San Tee0Chi-Tung Cheng1Chi-Hsun Hsieh2Shih-Ching Kang3Chih-Yuan Fu4Brian A. Derstine5Grace L. Su6Stewart C. Wang7Division of Trauma and Emergency Surgery, Department of Surgery, Linkou Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan City 33302, TaiwanDivision of Trauma and Emergency Surgery, Department of Surgery, Linkou Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan City 33302, TaiwanDivision of Trauma and Emergency Surgery, Department of Surgery, Linkou Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan City 33302, TaiwanDivision of Trauma and Emergency Surgery, Department of Surgery, Linkou Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan City 33302, TaiwanDivision of Trauma and Emergency Surgery, Department of Surgery, Linkou Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan City 33302, TaiwanMorphomic Analysis Group, University of Michigan, Ann Arbor, MI 48109, USAMorphomic Analysis Group, University of Michigan, Ann Arbor, MI 48109, USAMorphomic Analysis Group, University of Michigan, Ann Arbor, MI 48109, USA<i>Introduction:</i> The severity of injury from motor vehicle crashes (MVCs) depends on complex biomechanical factors, and the bodily features of the injured person account for some of these factors. By assuming that vulnerable road users (VRUs) have limited protection resulting from vehicles and safety equipment, the current study analyzed the characteristics of fat distribution measured by computed tomography (CT) imaging and investigated the existence of a “cushion effect” in VRUs. <i>Materials and Methods:</i> This retrospective study enrolled 592 VRUs involved in MVCs who underwent CT scans. Visceral fat area and subcutaneous fat cross-sectional area were measured and adjusted according to total body area (TBA) and are presented as the visceral fat ratio and the subQ fat ratio (subcutaneous fat ratio). Risk factors for serious abdominal injury (maximum abbreviated injury scale (MAIS<sub>abd</sub> ≥ 3)) resulting from MVCs were determined by univariate and multivariate analysis. <i>Results:</i> MAIS<sub>abd</sub> ≥ 3 was observed in 104 (17.6%) of the patients. The subQ fat ratio at the L4 vertebral level was significantly lower in the MAIS<sub>abd</sub> ≥ 3 group than in the MAIS<sub>abd</sub> < 3 group (24.9 ± 12.0 vs. 28.1 ± 11.9%; <i>p</i> = 0.015). A decreased L4 subQ fat ratio was associated with a higher risk for MAIS<sub>abd</sub> ≥ 3 in multivariate analysis (odds ratio 0.063; 95% CI 0.008–0.509; <i>p</i> = 0.009). <i>Conclusion:</i> The current study supported the “cushion effect” theory, and protection was apparently provided by subcutaneous fat tissue. This concept may further improve vehicle and safety designation in the future.https://www.mdpi.com/2227-9032/9/8/1006cushion effectobesitysubcutaneous fatvulnerable road user (VRU)abdominal injury |
| spellingShingle | Yu-San Tee Chi-Tung Cheng Chi-Hsun Hsieh Shih-Ching Kang Chih-Yuan Fu Brian A. Derstine Grace L. Su Stewart C. Wang Does a “Cushion Effect” Really Exist? A Morphomic Analysis of Vulnerable Road Users with Serious Blunt Abdominal Injury Healthcare cushion effect obesity subcutaneous fat vulnerable road user (VRU) abdominal injury |
| title | Does a “Cushion Effect” Really Exist? A Morphomic Analysis of Vulnerable Road Users with Serious Blunt Abdominal Injury |
| title_full | Does a “Cushion Effect” Really Exist? A Morphomic Analysis of Vulnerable Road Users with Serious Blunt Abdominal Injury |
| title_fullStr | Does a “Cushion Effect” Really Exist? A Morphomic Analysis of Vulnerable Road Users with Serious Blunt Abdominal Injury |
| title_full_unstemmed | Does a “Cushion Effect” Really Exist? A Morphomic Analysis of Vulnerable Road Users with Serious Blunt Abdominal Injury |
| title_short | Does a “Cushion Effect” Really Exist? A Morphomic Analysis of Vulnerable Road Users with Serious Blunt Abdominal Injury |
| title_sort | does a cushion effect really exist a morphomic analysis of vulnerable road users with serious blunt abdominal injury |
| topic | cushion effect obesity subcutaneous fat vulnerable road user (VRU) abdominal injury |
| url | https://www.mdpi.com/2227-9032/9/8/1006 |
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