Journal de recherche médico-légale

Predictive Factors of Severe Abdominal Injuries due to Seatbelt Compression in Motor Vehicle Passengers: A Nationwide Collision Data-based Study

Abstract

Masahito Hitosugi, Kiyoshi Ikegami, Kohei Takashima, Yuki Sugitani, Hitoshi Ida, Masashi Aoki and Michihisa Asaoka

Background: Abdominal injuries due to seatbelt have often occurred in motor vehicle passengers. Although seatbelt-induced moderate and severe abdominal injuries have been reported, factors associated with the occurrence of severe abdominal injuries were not examined.

Objectives: To clarify the pattern and severity of seatbelt-induced abdominal injuries and determine the predictive factors of severe abdominal injuries.

Methods: Among the data set of the National Automotive Sampling System/Crashworthiness Data System of collisions that occurred from 1995 to 2011, we chose right front-seat passengers with a height of >140 cm who developed seatbelt-induced abdominal injuries with an Abbreviated Injury Scale score of ≥ 2 during a frontal collision.

Results: The study population comprised 79 persons (24 male, 55 female; mean age, 37.5 years) with 136 abdominal injuries. Spleen, kidney, and liver injuries were the three most common seatbelt-induced injuries. The spleen was the most commonly injured site in both the moderate and severe injury groups. The liver was the second most commonly injured site in the moderate injury group, but no liver injuries occurred in the severe injury group (p=0.001). The multivariable logistic regression analysis revealed that force to the lower abdomen positively influenced the occurrence of severe injuries and that airbag deployment negatively influenced the occurrence of severe injuries.

Conclusions: Correct seatbelt use and airbag deployment can prevent severe seatbelt-induced abdominal injuries. Forensic pathologists should still suspect moderate abdominal injuries even in correct restrained vehicle passengers.