THE USE OF ACTIVE MOTOR VEHICLE RESTRAINSTS IS A TOPIC OF CURRENT PUBLIC AND LEGISLATIVE DEBATE. TO BETTER DEFINE THE EFFECTS OF RESTRAINT SYSTEMS ON INJURY SEVERITY, THE FOLLOWING STUDY WAS UNDERTAKEN. PARAMETRIC STATISTICAL TESTS WERE USED FOR DATA ANALYSES. FOR A 6-MONTH PERIOD BEGINNING FEBRUARY 1, 1987, ALL MOTOR VEHICLE CRASH VICTIMS TREATED IN THE EMERGENCY UNIT WERE ENTERED INTO THE STUDY (N=613). THERE WERE 290 UNRESTRAINED SUBJECTS (UR), 254 RESTRAINED SUBJECTS (R), AND 69 WERE EXCLUDED BECAUSE RESTRAINT USAGE INFORMATION WAS UNOBTAINABLE. UNRESTRAINED VICTIMS WERE YOUNGER (MEAN AGE, UR=28, R=32; P<0.05), AND WERE MORE OFTEN MALE (UR=65%, R=51%; P<0.05). HOSPITALIZATION WAS MORE FREQUENTLY REQUIRED FOR UNRESTRAINED CRASH VICTIMS (UR=59%, R=26%; P<0.05). LENGTH OF HOSPITAL STAY (LOS), INCLUDING ICU CONFINEMENT, WAS ALSO EXTENDED (MEAN LOS, UR=13, R=10), BUT THIS DIFFERENCE DID NOT REACH STATISTICAL SIGNIFICANCE. INJURY SEVERITY SCORES (ISS) AND ABBREVIATED INJURY SCALES (AIS) WERE TABULATED AND COMPARED. MEAN ISS WAS SIGNIFICANTLY HIGHER FOR UNRESTRAINED VICTIMS (UR=8.28, R=4.44; P<0.05), AND A HIGHER PROPORTION OF UNRESTRAINED VICTIMS HAD SCORES GREATER THAN 15 (UR=20%, R=7%; P <0.05). MEAN AIS WAS HIGHER IN ALL REGIONS, ALTHOUGH THE DIFFERENCE DID NOT CONSISTENTLY REACH STATISTICAL SIGNIFICANCE. AN ANALYSIS OF HOSPITAL CHARGES AND DISTRIBUTION OF METHODS OF PAYMENT INDICATE BOTH SIGNIFICANTLY GREATER MEAN HOSPITAL CHARGES (UR=$9631, R=$3429; P <0.05) AND A GREATER PROPORTION OF POTENTIALLY UNREIMBURSED ACCOUNTS (UR=36%, R=27%; P<0.05) IN THE UNRESTRAINED GROUP. THE CONCLUSIONS ARE AS FOLLOWS: THE USE OF SAFETY BELTS BY MOTOR VEHICLE OCCUPANTS REDUCES INJURY SEVERITY AND THE NEED FOR HOSPITALIZATION. ACCORDINGLY, HOSPITAL CHARGES AND LOS ARE PROPORTIONALLY LESS FOR RESTRAINED MOTOR VEHICLE CRASH VICTIMS.
Abstract