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Susceptibility of the aging thorax to motor vehicle crash injuries (922.2)
Author(s) -
Sochor Mark,
Heltzel Sara,
Kent Richard
Publication year - 2014
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.28.1_supplement.922.2
Subject(s) - thorax (insect anatomy) , rib cage , medicine , sagittal plane , anatomy , poison control , body mass index , crashworthiness , crash , orthodontics , environmental health , computer science , programming language
Susceptibility of the Aging Thorax to Motor Vehicle Crash Injuries Objective: Evaluate the appearance of the phenomenon that the aging thorax ribs become more horizontally oriented. It is hypothesized that the more horizontal orientation of the rib cage appears to cause more rib fractures in the elderly population when exposed to crash forces through a seat belt. It is well documented that thoracic injury tolerance decreases with age. Cadaver and field data (National Automotive Sampling System) have shown that older subjects generally sustain more rib fractures for a similar impact severity. Methods: Full thorax computed tomography (CT) scans of 60 patients age 18 to 89 years were analyzed to quantify the angle of the ribs in the sagittal plane. A standardized method of measuring the angle of the rib in relation to the thoracic spine was developed. Additionally, height, weight and Body Mass Index (BMI) were combined in a dataset to look for the relationship between these different factors. Results: Slope of the regression line with age was significantly different than zero with rib angle increasing with increasing age. Average increase in rib angle was about 4 degrees from young adult 18 years to elderly adult 88 years. Surprisingly, Weight and BMI were found to be significantly related to rib angle (p<.001). The rib angles increased from 45 degrees at 40kg to 68 degrees at 160kg. Conclusions: Rib angles become more horizontal with increasing age but this increase appears to be minimal (<5 degrees). What appears to actually drive rib angle more horizontally is weight. Limitations of the study is obviously geometric change of the thorax is not the only change in the elderly thorax as kyphosis and osteoporosis also occur simultaneously and will also have large effects.