Less than half of pediatric car passengers suffering injuries from motor vehicle crashes were restrained, with the lowest rates among blacks, Hispanics and Native Americans, according to a research abstract presented Saturday, Oct. 15, at the American Academy of Pediatrics (AAP) National Conference and Exhibition (NCE) in Boston.
While motor vehicle crashes are the leading cause of death among children, there is little data regarding the racial/ethnic differences in injury severity, use of seat belts and outcomes. In the study, "Are There Racial/Ethnic Disparities in the Use of Restraints and Outcomes in Children Following Motor Vehicle Crashes?" researchers reviewed 2002-2006 data from the National Trauma Database on car accidents involving nearly 40,000 children under age 16. Specifically, the study authors looked at the race/ethnicity of the children, whether or not they wore a seat belt, and the severity of their injury as determined by the need for emergency surgery, length of hospital stay, and morbidity/mortality.
Overall, 47.5 percent of patients were restrained, with the lowest use of seat belts among black, Hispanic and Native American children. Of the children injured, 12.6 percent required an emergency operation. Overall morbidity was 6.7 percent; and mortality, 5.8 percent. While race/ethnicity did not affect mortality or length of hospital stay, the use of restraints was associated with a lower injury severity score (ISS). A higher ISS was associated with an increased need for emergency surgery, morbidity (severe outcome), death and longer hospital stay.
"After adjusting for the use of restraints, we found no differences in mortality among different ethnic groups. The major determinant of both morbidity and mortality is the severity of the injury as quantified by the initial injury severity score," said lead study author Rebecca Stark, MD. "Because the use of restraints decreases the ISS, we feel our results highlight the need for further education and outreach to the pediatric population about the benefit of seat belt use."