title: Impact of airbags on a Level I trauma center: injury patterns, infectious morbidity, and hospital costs.
abstract: BACKGROUND
  To date, no study has evaluated the potential impact of supplemental restraint use on resource use at a Level I trauma center. We hypothesized that airbag use would be related to decreased injury severity of motor vehicle collision survivors admitted to a Level I trauma center, leading to a decrease in infectious morbidity and hospital resource use.
  
  
  METHODS
  Using the trauma registry, motor vehicle collision victims admitted during an 11-year period were identified. Restraint groups were defined as unrestrained (reference group), seatbelt only, airbag only, or airbag and seatbelt. Multivariable logistic regression was used to determine the relationship between restraint type and injury patterns. Other outcomes measured included prevalence of ventilator-associated pneumonia and bacteremia, hospital length of stay, days in the ICU, and hospital mortality.
  
  
  RESULTS
  A total of 14,390 patients (unrestrained, n = 7,881; airbag only, n = 692; seatbelt only, n = 4,909; airbag and seatbelt, n = 908) had restraint data available. Both airbag and seatbelt use were associated with a substantial reduction in injury to the brain, face, cervical spine, thorax, and abdomen. The largest reduction occurred when these restraints were used in combination. The only injury associated with airbag deployment was extremity fractures. Compared with unrestrained persons, any restraint use was associated with substantially reduced injury severity, significant infectious morbidity, and resource use.
  
  
  CONCLUSIONS
  Airbags are associated with reduced in-hospital mortality. Airbags are also associated with decreased injury severity, substantial infectious morbidity, and resource use. Cost savings from reduced resource use associated with supplemental restraints could be tremendous.
authors.affiliation: Department of Surgery, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
authors.forename: Regan F
authors.initials: RF
authors.lastname: Williams
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Fabian
authors.forename: Peter E
authors.initials: PE
authors.lastname: Fischer
authors.forename: Ben L
authors.initials: BL
authors.lastname: Zarzaur
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Magnotti
authors.forename: Martin A
authors.initials: MA
authors.lastname: Croce
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D017278:Air Bags / Q000706:statistics & numerical data*; D017046:Cost Savings; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007239:Infections / Q000453:epidemiology* / Q000209:etiology; D015601:Injury Severity Score; D008297:Male; D013714:Tennessee / Q000453:epidemiology; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000145:classification / Q000150:complications / Q000191:economics / Q000453:epidemiology*