{
  "abstract": "Traffic accidents are an inherent consequence of modern transportation and mobility systems. Changes in the post‑crash care system over the past fifty years may have influenced the survival prospects of injured vulnerable road users (VRUs) involved in traffic accidents. We therefore focused on assessing injury severity among fatally injured VRUs in Czechia. We analysed Injury Severity Scores (ISS) derived retrospectively from autopsy documentation (medical autopsy reports and forensic expert opinions) for a random sample of 15 deceased pedestrians and cyclists from each selected year (every fifth year) between 1969 and 2024 who underwent autopsy at Olomouc University Hospital (Czechia). We focused on trends in the first quartile of ISS values and applied a non‑parametric trend analysis to determine statistical significance. There was a statistically significant upward trend in the first quartile of ISS values over the study period, indicating an upward shift in the lower tail of trauma severity among fatal cases. One possible interpretation is that less severely injured VRUs may have become less represented among fatalities over time; however, this pattern cannot be attributed directly to improvements in post-crash care. It may also reflect changes in crash severity, exposure patterns, case mix, referral pathways, reporting practices, or documentation. Accordingly, Q25 ISS should be interpreted only as an indirect, hypothesis-generating proxy compatible with long-term changes in survivability, not as direct evidence that post-crash care improved.",
  "abstract_shown": true,
  "affiliations": [
    "CDV – Transport Research Centre, Brno, Czechia",
    "Palacky University in Olomouc, Olomouc, Czechia"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Michal Bíl"
    },
    {
      "affs": [
        1
      ],
      "name": "Richard Andrášik"
    },
    {
      "name": "Václav Svrchokryl"
    },
    {
      "name": "Martin Dobiáš"
    },
    {
      "name": "Martina Bílová"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5cftp4qpjtvv3.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0358958",
  "fulltext_url": null,
  "id": "5cftp4qpjtvv3",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0358958",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2213|Traffic and Road Safety"
    ],
    [
      "plos",
      "/Engineering and technology/Civil engineering/Transportation infrastructure/Roads"
    ],
    [
      "plos",
      "/Engineering and technology/Transportation/Transportation infrastructure/Roads"
    ],
    [
      "plos",
      "/Medicine and health sciences/Critical care and emergency medicine/Trauma medicine/Traumatic injury"
    ],
    [
      "plos",
      "/Medicine and health sciences/Diagnostic medicine/Clinical laboratory sciences/Forensics"
    ],
    [
      "plos",
      "/Medicine and health sciences/Diagnostic medicine/Clinical laboratory sciences/Forensics/Forensic pathology"
    ],
    [
      "plos",
      "/Medicine and health sciences/Epidemiology/Medical risk factors/Traumatic injury risk factors/Road traffic collisions"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pathology and laboratory medicine/Forensic pathology"
    ],
    [
      "plos",
      "/Medicine and health sciences/Public and occupational health/Traumatic injury risk factors/Road traffic collisions"
    ],
    [
      "plos",
      "/Medicine and health sciences/Surgical and invasive medical procedures/Autopsy"
    ],
    [
      "plos",
      "/People and places/Geographical locations/Europe/European Union/Czech Republic"
    ],
    [
      "plos",
      "/Research and analysis methods/Research facilities/Information centers/Archives"
    ]
  ],
  "openalex": "W7214305636",
  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0358958&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-25",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/5cftp4qpjtvv3.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:43Z",
      "native_id": "10.1371/journal.pone.0358958",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0358958"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:epidemiology",
      "subfield": "epidemiology-public-health"
    },
    {
      "field": "medicine",
      "origin": "plos:surgical and invasive medical procedures",
      "subfield": "surgery"
    }
  ],
  "title": "Vulnerable road user fatalities are associated with greater trauma: Long-term autopsy-based trends in Czechia (1969–2024)",
  "title_text": "Vulnerable road user fatalities are associated with greater trauma: Long-term autopsy-based trends in Czechia (1969–2024)",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:43Z",
  "url": "https://research.draconitic.com/paper/5cftp4qpjtvv3",
  "venue": "PLOS One",
  "versions": []
}