Pharmacologic TLR4 Inhibition Skews Astrocytes Toward a Favorable A1/A2 Ratio Improving Neurocognitive Outcomes Following Traumatic Brain Injury
Simon Rahal, Mahmoud El Baassiri, William Fulton, Chhinder Sodhi, *Isam W. Nasr
John Hopkins, Baltimore, MD
Background (issue): Investigating biomechanics of injury patterns from motor vehicle collisions (MVCs) informs improvements of vehicle safety. This study aims to investigate two-vehicle MVCs involving a passenger vehicle (PV) and the specific injury patterns associated with sources of injury, collision biomechanics, vehicle properties, and patient outcomes.
Methods: Retrospective cohort study conducted to evaluate the biomechanics of specific injury patterns seen in MVCs involving passenger vehicles using the Crash Injury Research Engineering Network (CIREN) database between the years 2005-2015.
Findings: A total of 631 MVC cases included from 2005-2015. Most cases involved injuries to head/neck, thorax, and abdomen (80.5%). Head/neck injuries were most commonly caused by airbags (38%), were associated with a significantly higher ISS compared to those from seatbelts (26.11 vs 18.28, p<0.001) and airbags (26.11 vs 20.10, p=0.006) as well as 6.4 times higher fatality rate compared to head/neck injuries from seatbelts (p=0.019). Thoracic injuries caused by the center console were 2.4 times more likely to result in fatalities than those caused by the seatbelt (p=0.09).
Conclusions (implications for practice): Occupants suffering injuries to the head/neck, thorax, and abdomen had a higher average ISS and fatality rate compared to other body regions, demonstrating that manufacturing and safety guidelines should focus on minimizing these injury patterns. Head/neck injuries caused by the steering wheel were associated with worse outcomes compared to those caused by seatbelts and airbags, further emphasizing the benefits of these critical safety features. Integration of innovative safety features like center-mounted airbags may improve occupants safety.
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