Clinical implications of the seat belt sign in blunt trauma.
Patients with the seat belt sign (SBS) from motor vehicle crashes (MVCs) are prone to specific regional injury patterns. Investigators at a Level 1 trauma center analyzed the incidence, clinical implications, and spectrum of regional injuries in patients injured in MVC over 2 years. SBS was seen in 11.3 per cent of patients injured in MVCs and 20.5 per cent of patients with known restraint use. Restrained patients were less severely injured with lower injury severity scores (7.62 vs 11.33) and mortality (1.1 vs 5.7%). Patients with SBS had lower mortality rates than patients without SBS (1.4 vs 3.7%). Thoraco-abdominal injuries were present in 47 per cent (34 of 72) of patients with SBS. Compared with patients without SBS, patients had a higher incidence of hollow viscous injuries (HVI) and solid organ trauma (8 and 17% vs 1 and 3%, P < 0.05); splenic trauma was 24-fold higher (9.7 vs 0.4%), liver injuries 3.1-fold higher (6 vs 3%), and rib fractures 2.4-fold higher (P < 0.05). Children had 2.8-fold higher rates of HVI (18 vs 9%, P < 0.05). SBS is associated with underlying regional injuries in nearly half of patients with a higher prevalence of HVI and solid organ trauma.
Sharma
Om P
OP
Trauma Services, The Toledo Hospital & Toledo Children's Hospital, Toledo, Ohio, USA.
Oswanski
Michael F
MF
Kaminski
Brian P
BP
Issa
Nabil M
NM
Duffy
Brian
B
Stringfellow
Kathryn
K
Lauer
Sherry K
SK
Stombaugh
Heather A
HA
D000007:Abdominal Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D006801:Humans; D015994:Incidence; D009104:Multiple Trauma / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D011446:Prospective Studies; D012622:Seat Belts; D015996:Survival Rate / Q000639:trends; D013898:Thoracic Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control