Seat Belt Use to Save Face: Impact on Drivers' Body Region and Nature of Injury in Motor Vehicle Crashes

Background: Seat belt use is the single most effective way to save lives and reduce injuries in motor vehicle crashes. However, some case reports described seat belt use as a double-edged sword because some injuries are related to seat belt use in motor vehicle crashes. To comprehensively understand the effects of seat belt use, we systemically investigated the association between seat belt use and injuries based on anatomic body region and type of injury in drivers involved in motor vehicle crashes. Methods: The injury information was obtained by linking crash reports with hospital discharge data and categorized by using the diagnosis codes based on the Barell injury diagnosis matrix. A total of 10,479 drivers (>= 15years) in passenger vehicles involved in motor vehicle crashes from 2006 to 2011 were included in this study. Results: Seat belt use significantly reduced the proportions of traumatic brain injury (10.4% non-seat belt; 4.1% seat belt) and other head, face, and neck injury (29.3% non-seat belt; 16.6% seat belt) but increased the proportion of spine: thoracic to coccyx injury (17.9% non-seat belt; 35.5% seat belt). Although the proportion of spine: thoracic to coccyx injury was increased in drivers with seat belt use, the severity of injury was decreased, such as fracture (4.2% with seat belt use; 22.0% without seat belt use). Furthermore, the total medical charges decreased due to the change of injury profiles in drivers with seat belt use from a higher percentage of fractures (average cost for per case $26,352) to a higher percentage of sprains and/or strains ($1,897) with spine: thoracic to coccyx injury. Conclusion: This study provide a comprehensive picture for understanding the protective effect of seat belt use on injuries based on anatomic body region and type of injury in drivers involved in motor vehicle crashes.