INTRODUCTION: There is no specific injury among fatally injured frontal 
car-occupants in frontal car collisions, used in forensic expertise. We tried to 
point out the usefulness of the Abbreviated Injury Scale (AIS) and Injury 
Severity Score (ISS) for the expertise in such cases.
OBJECTIVE: Analyzing the severity of body region injuries and total injury 
severity of deceased car occupants, to point out their importance in forensic 
expertise.
METHOD: Retrospective autopsy study was performed. Autopsy records of all 
deceased car-occupants in frontal car collisions were analyzed in order to 
establish the severity of injuries in body regions (AIS) and total severity of 
injuries (ISS). Statistical analysis was performed using the chi-square test, 
t-test, and logistic regression, with significance set at p < 0.05.
RESULTS: A total of 500 cases were analyzed: 282 car-drivers and 218 front 
car-passengers, average age of 41.48 +/- 15.31 and 39.78 +/- 16.93. There were 
401 males and 99 females. The most injured body region was head with neck: AIS = 
3.50 +/- 2.48, for car-drivers, and AIS = 3.54 +/- 2.50, for front 
car-passengers, as well as thorax: AIS = 3.63 +/- 2.16 car-drivers, and AIS = 
3.37 +/- 2.14, for front car-passengers. More severe injuries of head (AIS > or 
=4) suggested that deceased was a front car-passenger (Wald = 13.27; p = 0.04). 
More severe injuries of thorax and abdomen (AIS > or =5) indicated that deceased 
was a car-driver (Wald = 5.72; p = 0.02, and Wald = 8.23; p = 0.01, 
respectively). The injury severity of the face and limbs were useless in such 
expertise (Wald = 1.72; p = 0.19, and Wald =0.89; p = 0.34, respectively). An 
average ISS was 57.31 +/- 20.16 for car-drivers, and 54.54 +/- 21.01 for front 
car-passengers. The ISS value was useless in expertise (t=1.50; p = 0.13, and 
Wald = 2.24; p = 0.13).
CONCLUSION: As the injury of the head is more severe, the deceased is more 
likely to be the front car-passenger. Severe thoracic and abdominal injuries are 
more characteristic for car-drivers. A total injury severity is useless for 
forensic expertise in cases of fatally injured in car collisions.