Anatomy of a Crash: Analysis of 102 Pedestrian and Bicyclist Fatalities.

Pedestrian and bicyclist fatalities have increased over the past decade in the United States. Factors proposed to explain this increase include the increased popularity of larger passenger vehicles, road design to accommodate faster-moving traffic, and poor road infrastructure. We analyzed a series of 102 pedestrian and bicyclist fatalities to determine which factors were involved. Results demonstrated substance abuse as the most common pertinent decedent medical history, a disproportionate number of crashes occurred during evening/nighttime hours, and most crashes involved larger passenger vehicles. The percentage of cases involving sport utility vehicles (SUVs) has increased over time. Injury pattern analysis demonstrated that smaller passenger vehicles at lower speeds were more likely to cause lower extremity fractures compared to SUVs. Alcohol was the most common decedent substance detected on toxicology, and decedents with a previous mental health history were more likely to have positive toxicology for illicit substances than those without. Sixty-three percent of cases lacked sidewalks, and 85% of cases lacked bike lanes. We compared the trends that we saw on a small scale to those seen nationally and uncovered certain novel associations from the perspective of medical examination.