背景:安全带的进步对于降低与机动车碰撞(MVCs)有关的发病率和死亡率至关重要。“安全带标志”(SBS)是一项重要的身体检查发现,数十年来一直指导管理。这项研究,包括系统评价和随机效应荟萃分析,评估当前文献中与腹内损伤和手术干预相关的SBS的可能性。
方法:从开始到2023年8月4日,对PubMed和Scopus数据库进行了搜索,以获得合格的研究。结果包括腹内损伤的患病率和手术干预的需要。应用Cochrane的偏倚风险(RoB)工具和纽卡斯尔-渥太华量表(NOS)评估偏倚风险和研究质量;使用Q统计和I2值评估异质性。
结果:搜索产生了9项观察性研究,涉及3050名患者,1937年(63.5%)的SBS呈阳性。任何腹内损伤的合并患病率为0.42,(95%CI0.28-0.58,I2=96%)SBS的存在与腹内损伤的几率增加显着相关(OR3.62,95%CI1.12-11.6,P=0.03;I2=89%),手术干预的可能性增加(OR7.34,95%CI2.03-26.54,P<0.001;I2=29%)。任何腹内损伤的测量都与高度异质性有关,I2=89%。
结论:这项荟萃分析表明,SBS的存在与腹内损伤的统计学上显著的更高可能性相关,并且需要手术干预。该研究具有高度异质性,可能是由于本研究过程中的技术进步,包括安全带设计和诊断成像灵敏度。需要更多最新数据的进一步研究来证实这些结果。
The advancement of seat belts have been essential to reducing morbidity and mortality related to motor vehicle collisions (MVCs). The \"seat belt sign\" (SBS) is an important physical exam finding that has guided management for decades. This study, comprising a systematic review and random-effects meta-analysis, asses the current literature for the likelihood of the SBS relating to intra-abdominal injury and surgical intervention.
PubMed and Scopus databases were searched from their beginnings through August 4, 2023 for eligible studies. Outcomes included the prevalence of intra-abdominal injury and need for surgical intervention. Cochrane\'s Risk of Bias (RoB) tool and the Newcastle-Ottawa Scale (NOS) were applied to assess risk of bias and study quality; Q-statistics and I2 values were used to assess for heterogeneity.
The search yielded nine observational studies involving 3050 patients, 1937 (63.5%) of which had a positive SBS. The pooled prevalence of any intra-abdominal injury was 0.42, (95% CI 0.28-0.58, I2 = 96%) The presence of a SBS was significantly associated with increased odds of intra-abdominal injury (OR 3.62, 95% CI 1.12-11.6, P = 0.03; I2 = 89%), and an increased likelihood of surgical intervention (OR 7.34, 95% CI 2.03-26.54, P < 0.001; I2 = 29%). The measurement for any intra-abdominal injury was associated with high heterogeneity, I2 = 89%.
This meta-analysis suggests that the presence of a SBS was associated with a statistically significant higher likelihood of intra-abdominal injury and need for surgical intervention. The study had high heterogeneity, likely due to the technological advancements over the course of this study, including seat belt design and diagnostic imaging sensitivity. Further studies with more recent data are needed to confirm these results.