A new study shows unbelted crash occupants represent 68 percent of patients dying in emergency departments

In the nation's first statewide study of its kind, the Injury Research Center of the Medical College of Wisconsin in Milwaukee has revealed new data on an old problem - people who don't use seatbelts. The researchers found that unbelted crash occupants who make it to an emergency department alive are more than three times as likely as belt users to die.

The team used data from the 2002 Crash Outcome Data Evaluation System (CODES)* for Wisconsin. They studied 23,920 crash occupants, ages 16 and over, who were treated in hospital-based emergency departments (ED)'s, statewide in 2002, and compared ED outcomes and characteristics of seatbelt users with non users. Their study appears in the March 10, online issue of Academic Emergency Medicine.

"Unbelted crash occupants represented 68 percent of the patients dying in the ED's," says lead author Shane Allen, a third year medical student. "Among motor vehicle crash patients who survived, only 20 percent of surviving unbelted occupants were successfully treated in an ED and discharged. The remainder required hospital admission."

Motor vehicle crashes are the leading cause of death for Americans ages two through 33 years. According to the National Highway Traffic Safety Administration, crash fatalities in Wisconsin rose from 763 in 2001, to 803 in 2002; while reported seatbelt use in the state dropped from 69 percent in 2001 to 66 percent in 2002.

When compared to seatbelt users, Wisconsin motorists who didn't use seatbelts were more likely to suffer severe injuries and require hospitalization, according to Allen's preceptor, Stephen Hargarten, M.D., M.P.H, professor and chairman of emergency medicine and director of the Injury Research Center. Dr. Hargarten also serves as chief of the emergency department at Froedtert Hospital, a major teaching affiliate of the Medical College.

According to the study, unbelted study patients also incurred higher ED bills (average $681 vs. $509). However for many, higher ED bills were just the start, in terms of economic and personal costs.

Unbelted survivors were more than twice as likely to be admitted to the hospital, and one and a half to nearly four times more likely to suffer moderate to severe injuries to the head, face, thorax, abdomen, spine and upper and lower extremities.

The researchers also found that those who didn't use seatbelts were more likely to be male (56 vs. 40 percent), have used alcohol (17 vs. 4 percent), be younger (average age 31 vs. 38 years old) and to be involved in single-vehicle accidents, such as rollovers (44 vs. 22 percent).

Shankaun Zhu, M.D., Ph.D., assistant professor of family and community medicine was Allen's co-mentor. Peter Layde, M.D., M.S., professor of family and community medicine, and medical student Carley Sauter, B.S., were co-investigators.