INJURY AND COST COMPARISON OF RESTRAINED AND UNRESTRAINED MOTOR VEHICLE CRASH VICTIMS (WITH DISCUSSION)

The use of active motor vehicle restraints is a topic of current public and legislative debate. To better define the effects of restraint systems on injury severity, the following study was undertaken. Parametric statistical tests were used for data analyses. For a 6-mo period beginning Feb. 1, 1987, all motor vehicle crash victims treated in the emergency unit were entered into the study (n=613). There were 290 unrestrained subjects (UR), 254 restained subjects (R), and 69 were excluded because restraint usage information was unobtainable. Unrestrained victims were younger (mean age, UR=28, R=32; p less than 0.05), and were more often male (UR=65%, R=51%; p less than 0.05). Hospitalization was more frequently required for unrestrained crash victims (UR=59%, R=26%; p less than 0.05). Length of hospital stay (LOS), including ICU confinement, was also extended (mean LOS, UR=13, R=10), but this difference did not reach statistical significance. Injury Severity Scores (ISS) and Abbreviated Injury Scales (AIS) were tabulated and compared. Mean ISS was significantly higher for unrestrained victims (UR=8.28, R=4.44; p less than 0.05), and a higher proportion of unrestrained victims had scores greater than 15 (UR=20%, R=7%; p less than 0.05). Mean AIS was higher in all regions, although the difference did not consistently reach statistical significance. An analysis of hospital charges and distribution of methods of payment indicate both significantly greater mean hospital charges (UR=$9,631, R=$3,429; p less than 0.05) and a greater proportion of potentially unreimbursed accounts (UR=36%, R=27%; p less than 0.05) in the unrestrained group. Conclusions: The use of safety belts by motor vehicle occupants reduces injury severity and the need for hospitalization. Accordingly, hospital charges and LOS are proportionally less for restrained motor vehicle crash victims.