Fatality risk higher in car crashes involving pedestrians in wheelchairs

1. The mortality rate in car crashes involving pedestrians in wheelchairs was 36% higher than the general population pedestrian mortality rate.

2. No crash avoidance maneuver was reported in approximately three-fourths of the fatal pedestrian crashes.

Evidence Rating Level: 3 (Average)

Study Rundown: The purpose of this study was to assess the characteristics of fatal pedestrian car crashes in wheelchair users as well as compare them to fatal car crashes in the general population. Data was assessed from two separate registries of fatal car crashes involving pedestrians in wheelchairs from 2006 to 2012. The mortality rate of pedestrians in wheelchairs involved in car crashes was found to be approximately one third higher than that of pedestrians in the general population. Men in wheelchairs were at a higher risk of death in a pedestrian car crash than women wheelchair users. When compared to men of the same age who did not use wheelchairs, it was found that wheelchair users aged 50-64 years old at a higher risk pedestrian death. Approximately half of the crashes examined occurred at an intersection, with a significant portion of these intersections lacking a traffic control device. Additionally, in three-quarters of intersection crashes, no crash avoidance maneuvers were detected.  Male drivers were found to be responsible for a significant amount of these crashes. Inappropriate speed and failure to yield right of way were some of the most common behavioral factors associated with fatal crashes.

While this study speaks to a poignant issue in today’s society the authors encountered limitation in matching data between sources. Further, the investigators noted that the number of fatal crashes reported in wheelchair users was most likely under reported which would then underestimate the difference in the number of fatal crashes between the general population and wheelchair users. Despite the study’s limitation, the study findings can serve to bolster the campaign for improved public awareness and policy measures for disabled individuals.

Click to read the study in BMJ Open

Relevant reading: Epidemiology of non-fatal US emergency room visits  for road crashes involving pedestrians in wheelchairs

In-Depth [retrospective cohort]: The purpose of this study was to assess the characteristics of fatal pedestrian car crashes in wheelchair users as well as compare them to victims of fatal crashes in the general population. Data was extracted from the National Highway Traffic Safety Association and LexisNexis US newspaper database. Mortality rate for pedestrians in wheelchairs was found to be 2.07/100 000 person years (CI95% 1.60 to 2.54), 36% higher than the general population (p=0.02). Men who used wheelchairs had a significantly higher risk of fatal pedestrian car crash compared to women wheelchair users (p <0.001). The risk of pedestrian death was 38% higher in males aged 50-64 years old who used a wheelchair compared to men who did not (p=0.04).  47.6% of the crashes assessed occurred in an intersection (CI95% 42.8 to 52.5), with 38.7% of these intersections lacking a traffic control device (CI95% 32.0 to 45.0). Male drivers composed 74.8% of the drivers associated with fatal crashes (CI95% 70.0 to 79.0). No crash avoidance maneuvers were seen in 76.4% of crashes.

Image: PD

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