Seatbelt Use and Traumatic Brain Injury Outcomes After Pediatric Motor Vehicle Collisions
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Published on: September 21, 2017
Victoria Melendez-Placa1, Samuel Andrade2, Omar Viswanath3
1Lake Nona HS.
Background:
Seatbelts and age-appropriate restraints reduce crash-related injuries, but associations with specific pediatric traumatic brain injury (TBI) outcomes require further characterization.
Objective:
To examine associations between documented seatbelt use, TBI severity, head computed tomography (CT) findings, and hospital admission after pediatric motor vehicle collisions.
Methods:
This retrospective study reviewed trauma registry and medical record data from a Level I pediatric trauma center. Of 179 collision-related cases identified among 1,095 pediatric trauma records, 138 had documented seatbelt status. Categorical outcomes were compared using chi-square and exact tests. A multivariable logistic regression examined hospital admission in 96 complete cases.
Results:
ED TBI severity was available for 97 patients: 74 mild, 6 moderate, and 17 severe. Seatbelt use was not significantly associated with severity (P = .098). Among 107 patients with available CT results, abnormal findings occurred in 17/56 (30.4%) with seatbelt use and 25/51 (49.0%) without seatbelt use (Pearson P = .048; Fisher exact P = .074). The prehospital Glasgow Coma Scale comparison was not significant (P = .075). Loss of consciousness and transfer status were associated with higher adjusted odds of hospital admission, whereas higher ED Glasgow Coma Scale scores were associated with lower odds.
Conclusion:
Abnormal CT findings were less frequent with seatbelt use, ED TBI severity did not differ significantly. Missing data, limited sample size, and unmeasured crash characteristics constrain causal interpretation.
