(Reuters Health) – Wearing a seatbelt may not prevent liver injuries in a car crash, but it could lessen their severity and make a major difference in consequences and costs, researchers say.
Among more than 50,000 people with liver injuries as a result of a car crash, those with severe liver injuries were twice as likely to die as those with mild or moderate liver injuries, researchers found.
People who were wearing seatbelts were much less likely to have a severe liver injury. The risk dropped a bit more when seatbelts and airbags were both used, but airbags alone did not affect injury severity.
“It has been known for some time that seatbelt use is associated with lower mortality in a car crash,” said lead author Audrey Renson of NYU Langone Hospital-Brooklyn in New York City.
“Although some may consider this common sense, there is still some controversy lingering around seatbelts possibly being harmful and that having an airbag means you don’t have to wear a seatbelt,” she said in an email.
Each year in the U.S., motor vehicle crashes result in 2 million emergency room visits, tens of thousands of deaths and a huge financial burden to the healthcare system of nearly $1 trillion dollars, the study team wrote March 29 online in the Journal of Epidemiology and Community Health.
Blunt abdominal trauma specifically accounts for a significant number of injuries in these accidents, they add.
The two most commonly injured organs after such a collision are the liver and spleen, said Dr. Eileen Metzger Bulger, chair of the American College of Surgeons Committee on Trauma and chief of trauma at Harborview Medical Center in Seattle, who was not involved in the study.
But while the spleen can be removed, the liver cannot, Bulger noted in an email.
Renson’s team analyzed data from the National Trauma Data Bank for 2010 through 2015 on patients 18 years and older who were in a vehicle crash, excluding motorcycles, and were either admitted to the hospital or died on arrival or en route.
The researchers classified liver injuries as low-grade (e.g., hematomas or shallow lacerations that rarely require surgery) or severe (e.g., ruptured hematomas with uncontrolled bleeding, deep lacerations and other situations requiring immediate repair).
Of the 51,202 patients in the study, 15% had severe liver injuries, and 15% of those patients died. Among patients with mild or moderate liver injuries, nearly 8% died.
About 14% of patients with severe injuries required surgery and 21% had some kind of complication, versus 5% and 15%, respectively, of those with less severe liver injuries.
Seatbelt-wearing patients were 21% less likely to suffer a severe liver injury, and those protected by both a seatbelt and airbag were 26% less likely.
While the results of the study might seem obvious, the findings reinforce the importance of wearing a seatbelt at all times, noted the study’s senior author, Dr. Marc Bjurlin, a surgeon at NYU Langone Hospital-Brooklyn.
SOURCE: https://bit.ly/2IbJs6w
J Epidemiol Comm Health 2018.
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