J Korean Soc Emerg Med.  2020 Oct;31(5):448-457.

Comparison of preventive effect of seat belt on traumatic brain injury by age in motor vehicle collision

• Chai HS
• Choe BH
• Hong SJ
• Kim SC
• Lee HJ
• Park KJ
• Lee JH
• Kim H
• Lee SW

Abstract

Objective
This study examined whether the preventive effects of the safety belt on traumatic brain injury (TBI) from motor vehicle collisions (MVCs) differ according to the occupants’ age.
Methods
This study was a retrospective, observational study. This study evaluated the crash data from 2011 to 2016 obtained from the Emergency Department-based Injury In-depth Surveillance registry. The injured occupants were categorized by age into young adults (age, 18-35 years; n=35,032), middle-aged adults (age, 36-55 years; n=34,507), and older adults (aged older than 55 years, n=21,895). The primary (TBI), secondary (intensive care unit [ICU] admission), and tertiary endpoint (mortality) were set. Multivariate logistic regression analysis was performed, and the adjusted odds ratios (aORs) of subgroups were calculated for study outcomes adjusted for any potential confounders.
Results
Among 91,434 patients, 61,205 used seat belts at the time of the crashes. Compared to the unbelted group, the belted group was less likely to have a TBI. A comparison of the aOR of subgroups for TBI revealed the odds ratio reduction to be the highest in young adults (aOR, 0.39; 95% confidence interval [CI], 0.32-0.47), followed by middle-aged adults (aOR, 0.39; 95% CI, 0.33-0.47) and older adults (aOR, 0.49; 95% CI, 0.42-0.56). In addition, seat belt use had a preventive effect on ICU admission and mortality at all subgroups, the effect of which decreased with age.
Conclusion
The protective effects of seat belts on TBI, ICU admission, and mortality from MVCs were reduced with age.

Keyword

Traffic collisions; Aged; Traumatic brain injuries; Seat belts