Can anatomical morphomic variables help predict abdominal injury rates in frontal vehicle crashes?

OBJECTIVE: Abdominal injuries resulting from vehicle crashes can be significant, in particular when undetected. In this study, abdominal injuries for occupants involved in frontal impacts were assessed using crash and medical data.
METHODS: Injury rates and patterns were first assessed with respect to thoracic injuries. A statistical analysis was then conducted to predict abdominal injury outcome using 18 covariate variables, including 4 vehicle, 4 demographic, and 10 morphomic, derived from computed tomography (CT) scans. More than 260,000 logistic regression models were fitted using all possible variable combinations. The models were ranked using the Akaike information criterion (AIC) and combined through the model-averaging approach to produce the optimal predictive model. The performance of the models was then assessed using the area under the curve (AUC).
RESULTS: The rate of serious thoracic injury was 2.49 times higher than the rate of abdominal injury. The associated odds ratio was 2.31 (P <.01). These results suggest a strong association between serious abdominal and thoracic injuries. The optimal model AUC was 0.646 when using solely vehicle data, 0.696 when combining vehicle and demographic data, 0.866 when combining vehicle and morphomic data, and 0.879 when combining vehicle, demographic, and morphomic data. These results suggest that morphomic variables better predict abdominal injury outcomes than demographic variables. The most important morphomics variables included visceral fat area, trabecular bone density, and spine angulation.
CONCLUSION: This study is the first to combine vehicle, demographic, and anatomical data to predict abdominal injury rates in frontal crashes.