The Impact of Seatbelt Use on Trauma Outcomes in Adult Motor Vehicle Collision Patients With Rib Fractures: A National ACS-TQP-PUF Database Analysis

Boserup, Brad; Sutherland, Mason; Paloka, Rinald; McKenney, Mark; Elkbuli, Adel

doi:10.1016/j.jss.2021.06.067

Cited by 6 publications

(7 citation statements)

References 20 publications

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“…Previous studies have demonstrated that seatbelt use is a protective factor against mortality and serious injury which is consistent with the lower MAIS and mortality observed in our study. 15,16 However, the observed higher number of injuries contradicts the literature. 15,16 A possible explanation for the increased number of injuries with seatbelt use is that seatbelts protect occupants from serious injuries by spreading kinetic forces over a greater body surface area, resulting in a greater number of injuries that are less severe.…”

Section: Discussionmentioning

confidence: 72%

“…15,16 However, the observed higher number of injuries contradicts the literature. 15,16 A possible explanation for the increased number of injuries with seatbelt use is that seatbelts protect occupants from serious injuries by spreading kinetic forces over a greater body surface area, resulting in a greater number of injuries that are less severe. 3 Finally, these findings further support the overwhelming evidence that seatbelt use is a protective factor against MVC-fatalities.…”

Section: Discussionmentioning

confidence: 72%

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Nationwide Analysis of Biomechanics of Motor Vehicle Collisions Involving Passenger Vehicle and Associated Outcomes: Towards Improving Vehicle Safety Standards and Regulations

Concepcion

Newsome

Alfaro

et al. 2022

The American Surgeon™

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Background Motor vehicle collisions (MVCs) pose significant mortality and economic burden on the United States. Biomechanics research may guide future vehicle innovation. The objective of this study is to investigate the biomechanics of two-vehicle MVCs involving passenger vehicle (PV) to evaluate associated injury patterns and outcomes including mortality. Methods A retrospective cohort study of cases from the Crash Injury Research Engineering Network database was performed to evaluate the biomechanics (angle of impact, seatbelt use, and airbag deployment) of two-vehicle MVCs involving at least one PV from 2005-2015. Results Out of 629 MVCs evaluated, lateral collisions were most common (49.5%), followed by head-on (41.3%) and rear-end (9.2%) collisions. Thoracic injuries accounted for 30.1%, 31.4%, and 31.1% of injuries in lateral, head-on, and rear-end collisions, respectively, and were the most common body region injured for all collision types. Seatbelt use was associated with shorter ICU stay (10.9 vs 19.1 days, P = .036) and mortality (Cramer’s V = .224, P < .001), but a greater average number of injuries (10.2 injuries vs 8.6 injuries, P = .011). Conclusion Passenger vehicle are commonly involved in MVCs nationwide and efforts are needed to prevent occupant injuries and fatalities. The incorporation of energy-absorbing material into common points of contact within the vehicle interior may decrease the severity of these injuries. Seatbelt use remains a protective factor against MVC-fatalities but is associated with collateral injuries and should be a focus of further innovation.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 72%

Nationwide Analysis of Biomechanics of Motor Vehicle Collisions Involving Passenger Vehicle and Associated Outcomes: Towards Improving Vehicle Safety Standards and Regulations

Concepcion

Newsome

Alfaro

et al. 2022

The American Surgeon™

Self Cite

View full text Add to dashboard Cite

show abstract

“…Nearly 25% of traumatic deaths are due to thoracic trauma. Seatbelt use may be protective against serious injuries in patients with thoracic injury, unrestrained drivers in RTIs suffer a signi cant thoracic injury [2]. Thoracic trauma frequently includes a pneumothorax, hemothorax, or hemopneumothorax, which may necessitate an Intercostal drainage (ICD) for air and uid evacuation to improve breathing and circulatory function [3].…”

Section: Introductionmentioning

confidence: 99%

Role of Low-pressure Negative Pleural Suction in Patients With Thoracic Trauma - a Randomized Controlled Trial.

Priyadarshi,

Gupta,

Priyadarshini

et al. 2024

Preprint

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Background: Thoracic trauma frequently includes a pneumothorax, hemothorax, or hemopneumothorax, which may necessitate an Intercostal drainage (ICD) for air and fluid evacuation to improve breathing and circulatory function. It is a simple and life-saving procedure; nevertheless, it carries morbidity, even after its removal. Efforts have been made continuously to shorten the duration of ICD, but mostly in non-trauma patients. In this study, we evaluated the impact of negative pleural suction over the duration of ICD. Methods: This study was a prospective randomized controlled interventional trial conducted at Level 1 Trauma Centre. Thoracic trauma patients with ICD, who met the inclusion criteria (sample size 70) were randomized into two groups, the first group with negative pleural suction up to -20 cm H2O, and the second group as conventional, i.e. ICD connected to underwater seal container only. The primary objective was to compare the duration of ICDs and the secondary objectives were the length of hospital stay and various complications of thoracic trauma. Results: Duration of ICD was measured in median days with minimum & maximum days. For the negative suction group, it was 4 days (2-16 days); for the conventional group, it was also 4 days (2-17 days). There was also no significant difference among both groups in length of hospital stay. Conclusion: The beneficial effect of negative pleural suction to ICD could not be demonstrated over the duration of ICD and hospital stay. In both groups, there was no significant difference in complication rates like recurrent pneumothorax, retained hemothorax, persistent air leak, and empyema. Level of evidence: Therapeutic Study, Level II

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“…Although it is beyond the scope of this report, clinicians emphasize that another contributing factor to mortality is the post-crash treatment rendered. To address fatal clinical injury associated with restraint use and nonuse for adults injured in a motor vehicle crash, clinicians have noted the importance of raising awareness of the need for quick assessment and diagnosis, particularly with regard to thorax injuries [9][10][11][12]. As an example, the condition of isolated right atrial rupture with cardiac tamponade in MV crash occupants is a difficult, but important diagnosis and must be surgically corrected quickly [9].…”

Section: Introductionmentioning

confidence: 99%

“…As an example, the condition of isolated right atrial rupture with cardiac tamponade in MV crash occupants is a difficult, but important diagnosis and must be surgically corrected quickly [9]. In the setting of airbag deployment, there are reports of an association between seatbelt sign and cervicothoracic injury [11]. Steering wheel deformity is an independent predictor of serious, life threatening thoracic injury in drivers and front seat passengers and is associated with serious abdominal injury among front seated passengers.…”

Section: Introductionmentioning

confidence: 99%

Fatal Motor Vehicle Crashes in Upstate and Long Island New York: The Impact of High Visibility Seat Belt Enforcement on Multiple Risky Driving Behaviors

Pressley

Puri

2023

IJERPH

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Despite an observed daytime front-seat seat belt use that exceeds 90%, nearly half of motor vehicle occupants who die in New York State (NYS) each year are not wearing a seat belt. Crash outcomes were examined by occupant, vehicle, environmental and traffic enforcement patterns related to the annual Click It or Ticket high visibility seat belt enforcement campaign. Three periods of enforcement were examined: pre-enforcement, peri-enforcement (during/immediately after), and post-enforcement. Of the 14.4 million traffic citations, 713,990 (5.0%) were seat belt violations. Relative risk with 95% CI was assessed using deaths from the Fatality Analysis Reporting System (FARS) and SAS Glimmix 9.4 software. Mortality was lower peri-enforcement (32.9%) compared to pre- (40.9%) or post-enforcement (37.1%) (p < 0.001) and tended to be elevated in low enforcement response areas (43.6%). Fatalities were 30% lower (0.7, 95% CI 0.6–0.9) during peri-enforcement in models adjusted for demographics, law coverage, enforcement response, rural, weekend, impairment, speeding, and vehicle type. Adjusted mortality was higher in rural (1.9, 1.6–2.6), alcohol-involved (1.8, 1.4–2.9), and speeding-involved (2.0, 1.7–2.5) crashes. Peri-enforcement alcohol- and speed-involved fatalities tended to be lower in restrained, unrestrained and occupants missing belt status. The finding of lower mortality in both belted and unbelted occupant’s peri-enforcement—in the context of fewer fatal speed and alcohol-involved crashes—suggests that the mechanism(s) through which high visibility seat belt enforcement lowers mortality is through impacting multiple risky driving behaviors.

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The Impact of Seatbelt Use on Trauma Outcomes in Adult Motor Vehicle Collision Patients With Rib Fractures: A National ACS-TQP-PUF Database Analysis

Cited by 6 publications

References 20 publications

Nationwide Analysis of Biomechanics of Motor Vehicle Collisions Involving Passenger Vehicle and Associated Outcomes: Towards Improving Vehicle Safety Standards and Regulations

Nationwide Analysis of Biomechanics of Motor Vehicle Collisions Involving Passenger Vehicle and Associated Outcomes: Towards Improving Vehicle Safety Standards and Regulations

Role of Low-pressure Negative Pleural Suction in Patients With Thoracic Trauma - a Randomized Controlled Trial.

Fatal Motor Vehicle Crashes in Upstate and Long Island New York: The Impact of High Visibility Seat Belt Enforcement on Multiple Risky Driving Behaviors

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