METHODS: We analyzed the National Trauma Data Bank (2017-2019) using ICD-10 codes to identify adult motor vehicle occupants with BI who underwent surgical repair. We used logistic regression modeling to compare the risk of undergoing surgical repair for BI after using a protective device.
RESULTS: Of 2,848,592 injured patients, 475,546 (16.7%) were motor vehicle occupants. Only 1.2% (n = 5627/475,546) of patients underwent a bowel repair or resection. Using a seat belt only was associated with an adjusted OR of 2.09 (95% CI 1.91, 2.28) for undergoing a bowel repair/resection when adjusting for Injury Severity Score (ISS) and age. Airbag deployment without a seat belt had an adjusted OR of 1.46 (95% CI 1.31, 1.62), while both devices combined conferred an OR of 3.27 (95% CI 3.02, 3.54). However, using a seat belt was protective against death with an OR of 0.50 (95% CI 0.48, 0.53), adjusted for age, sex, Charlson Comorbidity Score, and ISS.
CONCLUSIONS: Seat belts and airbags are essential public health safety interventions and protect against death in motor vehicle-associated injuries. However, patients involved in MVCs with airbag deployment or while wearing a seat belt are at an increased risk of bowel injury requiring surgery compared to unrestrained patients, despite these events being relatively uncommon.
方法:我们使用ICD-10代码分析了国家创伤数据库(2017-2019年),以识别接受手术修复的患有BI的成年机动车乘员。我们使用逻辑回归模型来比较使用保护装置后接受BI手术修复的风险。
结果:在2,848,592名受伤患者中,汽车乘员为475,546人(16.7%)。只有1.2%(n=5627/475,546)的患者接受了肠修复或切除术。当调整损伤严重程度评分(ISS)和年龄时,仅使用安全带与进行肠修复/切除的校正OR为2.09(95%CI1.91,2.28)相关。不带安全带的气囊展开调整后的OR为1.46(95%CI1.31,1.62),而两种装置组合的OR为3.27(95%CI3.02,3.54)。然而,使用安全带可以防止死亡,OR为0.50(95%CI0.48,0.53),根据年龄调整,性别,Charlson合并症评分,和ISS。
结论:安全带和安全气囊是必不可少的公共卫生安全干预措施,可以防止机动车相关伤害中的死亡。然而,与不受约束的患者相比,安全气囊展开或系上安全带的患者发生肠道损伤的风险增加,需要进行手术,尽管这些事件相对不常见。