title: Seatbelt Use and Traumatic Brain Injury in Taiwan: A 16-Year Study.
abstract: BACKGROUND
  A motor vehicle seat belt use law for the driver and front-seat passenger was implemented in Taiwan on June 1, 2001. The purpose of this study was to determine the effect of motor vehicle seat belt use on the severity of traumatic brain injuries because of motor vehicle accidents.
  
  
  METHODS
  Data were collected from 27 major teaching hospitals four years before June 1, 2001 and until May 31, 2013. A total of 822 brain-injured patients with a mean age of 37.4 (± 13.4) years were included; 251 were injured prior to implementation of the law and 571 after. The Glasgow coma scale was adapted to rate the severity of traumatic brain injury on admission. The Glasgow outcome scale was used to categorize the outcome on discharge.
  
  
  RESULTS
  After the seat belt law was implemented, traumatic brain injuries were less severe (P<0.001) and the rates of loss of consciousness, neurologic deficit, intracranial hematoma, craniotomy, and poor physical condition at discharge were all significantly lower (all P< 0.05). Male gender, longer hospital stays, not wearing a seat belt, and injury before the law was enacted were all associated with poorer physical condition at the time of discharge (all P <0.01).
  
  
  CONCLUSIONS
  Among occupants who survived a motor vehicle accident but had traumatic brain injuries, those who had worn seat belts had a better prognosis. Seat belts remain one of the best methods to reduce both the severity of injuries and the number of fatalities.
authors.affiliation: School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan ; Office of Medical Affairs, Shuang Ho Hospital, Taipei Medical University, Taiwan.
authors.forename: Chia-Ying
authors.initials: CY
authors.lastname: Kuo
authors.affiliation: School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hung-Yi
authors.initials: HY
authors.lastname: Chiou
authors.affiliation: Division of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, Taiwan ; College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Jia-Wei
authors.initials: JW
authors.lastname: Lin
authors.affiliation: School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan ; College of Medicine, Taipei Medical University, Taipei, Taiwan ; Dept. of Emergency Medicine, Shuang Ho Hospital, Taipei Medical University, Taiwan.
authors.forename: Shin-Han
authors.initials: SH
authors.lastname: Tsai
authors.affiliation: Division of Neurosurgery, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Yung-Hsiao
authors.initials: YH
authors.lastname: Chiang
authors.affiliation: Division of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, Taiwan.
authors.forename: Chien-Min
authors.initials: CM
authors.lastname: Lin
authors.affiliation: School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.
authors.forename: Wen-Ta
authors.initials: WT
authors.lastname: Chiu
keywords: Glasgow coma scale; Motor vehicle accident; Seat belt; Traumatic brain injury