Women Are More Likely than Men to Sustain Serious or Fatal Injuries in Car Crashes
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These findings add to a growing body of evidence showing disparities in motor vehicle crash outcomes with respect to biological sex, says Christopher J. Wolff, MD, a member of the acute care surgery, trauma, and critical care team at Cleveland Clinic Akron General in Ohio.
“I think the root of this paper highlights a simple question: Are we doing everything possible to protect and care for all people equally?” says Dr. Wolff, who was not involved in the study.
Women Sustain More Pelvis and Liver Injuries in Car Crashes
Researchers aimed to better understand if differences in male and female injury and death in vehicle crashes could also be found in the information hospitals record when a person arrives at the ER after being in a car accident.
By looking at clinical injury data, researchers were able to see the true outcomes of accidents, rather than risk estimations, giving them a unique viewpoint to evaluate whether car safety systems like seat belts and airbags work equally well for male and female bodies.
Using data from more than 56,000 car crash victims, half of whom were female, investigators found that even though men had more injuries overall, women had more pelvis and liver injuries.
New Finding: ‘Normal’ Vital Signs May Be Different for Males and Females
In a new finding that could have significant implications, researchers found that women surpassed a shock index greater than 1.0 more frequently than men. This was true even for women who had fewer total or less severe injuries than their male counterparts. An elevated shock index can be an early warning sign of hemorrhagic shock, caused by heavy blood loss, but can also be an early predictor of mortality, according to the authors.
Shock index is a quick calculation based on vital signs that can be used to estimate severity of illness, explains Wolff. It’s an important tool used to develop better ways to detect severe illness caused by critical injuries quickly and accurately, therefore allowing for early and appropriate interventions in order to save lives, he says.
The findings might mean that women’s bodies have less capacity to function when physiological changes occur. Perhaps some injuries have more impact on female bodies, or female bodies handle blood loss differently than male bodies, said Cronn.
“It might also be that we have been assuming that normal vital signs are the same for everyone regardless of sex, and that we need to revisit our definition of normal,” she said.
If further research shows that these findings could make a difference in patient care and outcomes, a sex-differentiated shock index may change how first aid responders and clinicians approach patients, the researchers wrote.
Although the shock index has its advantages, the results of this study may suggest that either biological females have different responses to trauma and injury, or that the understanding of normal and abnormal results in a biological female may not be as clear as previously thought, says Wolff. “More clinical research efforts are needed to better answer this question,” he says.
‘Should We Be Appalled That Crash Test Dummy Research Does Not Have a Test for an Average-Size Female?’
The findings on how injuries differed according to biological sex add to the accumulation of evidence showing disparities in motor vehicle crash outcomes, says Wolff. While there are many variables that still need to be studied, changes need to be made on a preventive health level to limit these, he says.
“Should we be appalled that crash test dummy research does not have a test for an average-sized female?” asks Wolff.
Female Crash Test Dummies Are Woefully Out-of-Date
The authors hope their results will help bring about changes. “We hope that we can delineate the impact of sex on crash injury further, so that vehicle safety engineering can consider important male and female body differences in their design, and that they provide insight for legislation and regulations as needed for equity in car safety design,” said Cronn.
In frontal crash tests for the NHTSA and the Insurance Institute for Highway Safety, the 5th percentile female either rides shotgun or doesn’t participate in the test at all — even though women now represent almost 50 percent of drivers in the United States.
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