The effect of age on injury patterns in pedestrian deaths

Although it is known that elderly pedestrians are at increased risk of injury and death from vehicle crashes the specific pattern of lethal injuries related to age has not been extensively studied. Data on the numbers of pedestrian fatalities and ages were obtained from 1990 to 2020 from the Traffic Accident Reporting System, The University of Adelaide, Adelaide, South Australia and detailed autopsy data on fatal pedestrian crashes from the pathology database at Forensic Science SA, Adelaide, South Australia from 2000 to 2020. Fatal injuries were separated into the following regions: head/face, spine, chest, abdomen and limbs/skeleton. Analysis of 634 cases of pedestrian fatalities (1990–2020) showed a significant decline in numbers over the years ( p < 0.001). Analysis of fatal injuries in 219 cases (2000–2020) showed a significant reduction in the proportion of fatal head injuries with increasing age ( p < 0.05), a significant increase in the proportion of fatal chest injuries with increasing age ( p < 0.01) and a significant increase in the proportion of fatal limb/skeletal injuries with increasing age ( p < 0.05). Older pedestrians are, therefore, more likely to sustain lethal chest and limb/skeletal injuries than head injuries compared to those who are younger, presumably due to greater physical fragility that occurs with age, with loss of protective muscle bulk and bone density.