Abstract：
BACKGROUND: Protective devices such as seat belts and airbags have improved the safety of motor vehicle occupants, but limited data suggest they may be associated with increased blunt bowel (small bowel or colon) injuries (BI). Unfortunately, this risk is unquantified.
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.
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.
摘要：
背景：安全带和安全气囊等保护装置提高了机动车乘员的安全性，但有限的数据表明，它们可能与钝性肠（小肠或结肠）损伤（BI）增加有关。不幸的是,这种风险是无法量化的。
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。
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。
