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Is the "seat belt sign" associated with serious abdominal injuries in pediatric trauma?

Sara Chidester1, Ankur Rana, Wendi Lowell

  • 1Bellevue Hospital, New York, New York, USA.

The Journal of Trauma
|July 11, 2009
PubMed

Insights

The seat belt sign (SBS) is not a reliable indicator of intra-abdominal injury in children after motor vehicle crashes. This study found no significant association, suggesting it may be less predictive than previously thought.

Area of Science:

  • Pediatric Trauma Surgery
  • Emergency Medicine
  • Abdominal Injury Diagnosis

Background:

  • The "seat belt sign" (SBS) is traditionally associated with intra-abdominal injuries in trauma patients.
  • Its predictive value in pediatric populations requires further investigation.

Purpose of the Study:

  • To determine the predictive value of the seat belt sign (SBS) for identifying intra-abdominal injuries in a large pediatric trauma cohort.
  • To assess the association between SBS and the severity of injury in children involved in motor vehicle crashes.

Main Methods:

  • Retrospective review of trauma flow sheets for pediatric motor vehicle crash victims (ages 0-20) requiring trauma team activation.
  • Inclusion criteria: abdominal SBS recorded during 2005-2006 at a Level I pediatric trauma center.

Main Results:

  • Of 331 patients, 54 (16%) had an SBS; 12 (22%) sustained abdominal injuries.
  • Patients without SBS had a higher Injury Severity Score and accounted for all recorded deaths.
  • The SBS demonstrated a sensitivity of 25% and a specificity of 85% for abdominal injury.

Conclusions:

  • The seat belt sign (SBS) was not significantly associated with intra-abdominal injury in this pediatric trauma population.
  • SBS may not be as predictive of abdominal injury in children as previously reported in adult studies.
  • Clinical suspicion and other diagnostic tools remain crucial for identifying significant intra-abdominal injuries in pediatric trauma.
Abstract

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