• Shane Allen, Shankuan Zhu, Carley Sauter, Peter Layde, and Stephen Hargarten.
• Injury Research Center, Medical College of Wisconsin, Milwaukee, WI, USA.
• Acad Emerg Med. 2006 Apr 1;13(4):427-34.

ObjectivesTo investigate the association of seatbelt nonuse with injury patterns, injury severity, and in-patient hospital admission among adults presenting to emergency departments (EDs) in a statewide, population-based, sample of motor vehicle crashes.MethodsUsing data from the 2002 Crash Outcome Data Evaluation System (CODES) for Wisconsin, 23,920 occupants of motor vehicle crashes, aged 16 years or older, who were treated in an ED, were analyzed. Logistic regression was used to compare the odds ratio of having sustained an injury to specific body regions and of being admitted to an inpatient unit in unbelted individuals compared with those who were belted.ResultsCompared with belted occupants presenting to an ED, their unbelted counterparts were more likely to be male (56% vs. 40%) and to have used alcohol (17% vs. 4%). Unbelted occupants were younger (31 years vs. 38 years) and incurred higher ED charges ($681 vs. $509) than belted occupants. Additionally, unbelted occupants have a higher proportion of single-vehicle crashes, such as rollovers (44% vs. 22%), and rural crashes (56% vs. 44%). Unbelted occupants comprised 20% of study patients treated in the ED and discharged, 44% of patients treated in the ED and admitted, and 68% of patients dying in the ED. Unbelted occupants were more likely to be admitted (odds ratio [OR] = 2.6) than belted individuals and were more likely to suffer severe injuries to the head, face, thorax, abdomen, spine, upper and lower extremities (OR ranging from 1.6 to 3.9).ConclusionsAmong patients presenting to an ED after a motor vehicle crash, unbelted occupants are more likely to require inpatient admission and to have sustained a severe injury to numerous body regions than are belted occupants.

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