title: Restraints and peripheral nerve injuries in adult victims of motor vehicle crashes.
abstract: The pattern of injuries in restrained victims of motor vehicle crashes (MVCs) remains an issue of debate. We investigated the association of peripheral nerve injuries with the use of protective devices (seat belt and air bag) during MVCs. We performed a retrospective cohort study of 384,539 adult MVC victims who were registered in the National Trauma Data Bank (NTDB) between 2009 and 2011. Regression techniques were used to investigate the association of restraint use with the risk of peripheral nerve injury in patients hospitalized after an MVC. Of the study patients, 271,099 were using restraints and 113,440 were not. Overall, there were a total of 3086 peripheral nerve injuries. Multivariable logistic regression analysis demonstrated an association of protective device use with decreased risk of peripheral nerve injury (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.82-0.96; absolute risk reduction, 10.68%). This corresponds to 16 patients who needed to be restrained to prevent one nerve injury. The location of the patient in the vehicle did not seem to affect the risk of peripheral nerve injury, with drivers demonstrating no association with nerve injuries (OR, 0.94; 95% CI, 0.87-1.02) in comparison with non-drivers. On the contrary, alcohol consumption was associated with increased incidence of peripheral nerve injuries (OR, 1.10; 95% CI, 1.01-1.20). In summary, restraint use was associated with decreased risk of peripheral nerve injury in MVC victims, after controlling for confounders.
authors.affiliation: 1 Section of Neurosurgery, Dartmouth-Hitchcock Medical Center , Lebanon, New Hampshire.
authors.forename: Kimon
authors.initials: K
authors.lastname: Bekelis
authors.forename: Symeon
authors.initials: S
authors.lastname: Missios
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Spinner
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D017278:Air Bags / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D059348:Peripheral Nerve Injuries / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D012042:Registries / Q000706:statistics & numerical data*; D012622:Seat Belts / Q000706:statistics & numerical data*
keywords: NTDB; air bag; motor vehicle crash; peripheral nerve injury; seat belt