|
 Among more than 50,000 people with liver injuries as a result of a
car crash, those with severe liver injuries were twice as likely to
die as those with mild or moderate liver injuries, researchers
found.
They also found that people who were wearing seatbelts were much
less likely to have a severe liver injury. The risk dropped a bit
more when seatbelts and airbags were both used, but airbags alone
did not affect injury severity.
"It has been known for some time that seatbelt use is associated
with lower mortality in a car crash," said lead author Audrey Renson
of NYU Langone Hospital-Brooklyn in New York City.
"Although some may consider this common sense, there is still some
controversy lingering around seatbelts possibly being harmful and
that having an airbag means you don’t have to wear a seatbelt," she
said in an email.
Each year in the U.S., motor vehicle crashes result in 2 million
emergency room visits, tens of thousands of deaths and a huge
financial burden to the healthcare system of nearly $1 trillion
dollars, the study team writes in the Journal of Epidemiology and
Community Health.
Blunt abdominal trauma specifically accounts for a significant
number of injuries in these accidents, they add.
The two most commonly injured organs after such a collision are the
liver and spleen, said Dr. Eileen Metzger Bulger, chair of the
American College of Surgeons Committee on Trauma and chief of trauma
at Harborview Medical Center in Seattle, who was not involved in the
study.
"Both can cause severe bleeding, but the spleen can be removed if
needed during surgery, which controls the bleeding. The liver
(however) is critical for life and cannot be removed," Bulger said
by email.
Renson's team analyzed data from the National Trauma Data Bank for
2010 through 2015 on patients 18 years and older who were in a
vehicle crash, excluding motorcycles, and were either admitted to
the hospital or died on arrival or en route.
[to top of second column] |
The researchers classified liver injuries as low-grade or severe.
Low-grade injuries included blood clots or shallow lacerations and
others that rarely require surgery. Severe injuries included
ruptured clots with uncontrolled bleeding, deep lacerations and
other kinds of wounds that need immediate repair.
Overall, 51,202 injury cases included enough data to calculate an
injury severity score, the researchers note. Fifteen percent of
patients had liver injuries in the severe category, and 15 percent
of those patients died. Among patients with mild or moderate liver
injuries, nearly 8 percent died.
About 14 percent of patients with severe injuries required surgery
and 21 percent had some kind of complication, versus 5 percent and
15 percent, respectively, of those with less severe liver injuries.
Seatbelt-wearing patients were 21 percent less likely to suffer a
severe liver injury, and those protected by both a seatbelt and
airbag were 26 percent less likely.
Seatbelts and airbags appear to work together, Renson said, and the
effect of one is dependent on the other.
"Trauma can result in a number of serious complications during the
period surrounding the trauma, including bile leakage or obstruction
of bile flow, abscess formation, bleeding without the ability to
appropriately clot blood and an inability to filter metabolites
resulting in jaundice," noted the study's senior author, Dr. Marc
Bjurlin, a surgeon at NYU Langone Hospital-Brooklyn.
While the results of the study might seem obvious, the findings
reinforce the importance of wearing a seatbelt at all times, he
said.
SOURCE: https://bit.ly/2IbJs6w Journal of Epidemiology and Community
Health, online March 29, 2018.
[© 2018 Thomson Reuters. All rights
reserved.] Copyright 2018 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |
