Document Detail


Predictors of seatbelt use in American Indian motor vehicle crash trauma victims on and off the reservation.
MedLine Citation:
PMID:  17854575     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: American Indians (AI's) have the lowest rate of seatbelt use in the nation, putting them at significant risk for motor vehicle crash (MVC) morbidity and mortality. This study compares seatbelt use in victims of level one trauma crashes presenting from on and off AI reservations. Predictors of seatbelt use were evaluated as well. We hypothesized that AI's in crashes on a reservation would have lower rates of seatbelt use, even compared to AI's in crashes from off the reservation. METHODS: This is a retrospective cohort study of consecutive MVC victims presenting to a level one trauma facility in Phoenix, Arizona from July 2003 to June 2005. Inclusion criteria were age >11 and transported directly from the crash; struck pedestrians were excluded. Inter-facility transports were also excluded, as these patients would likely represent a sicker population, possibly introducing bias. Characteristics of those patients (sex, race, location of crash, alcohol and seatbelt use) were analyzed in univariate and multivariate logistic regression. RESULTS: Data were collected on 2339 patients. Three hundred ninety-two were excluded, leaving 1947 (83%) available for analysis. AI's had lower rates of seatbelt use compared to all other races. Additionally, AI's on a reservation were less likely to wear seatbelts than those off a reservation (25.9% versus 42.7%). However, when tested in a multivariate analysis with alcohol as a covariate, race and location became insignificant. Low seatbelt use by AI's on the reservation was primarily associated with alcohol use. CONCLUSION: In this analysis, alcohol, rather than race or location, is the overriding predictor of seatbelt use. This study compared patients that were in crashes, and only those triaged to a level one trauma facility. If we assume unbelted passengers are more severely injured, this would bias our results. The application of these data may help direct future public service efforts to increase seatbelt use in target populations.
Authors:
Eric A Gross; Amy Axberg; Kathleen Mathieson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-03-28
Journal Detail:
Title:  Accident; analysis and prevention     Volume:  39     ISSN:  0001-4575     ISO Abbreviation:  Accid Anal Prev     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-14     Completed Date:  2008-01-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1254476     Medline TA:  Accid Anal Prev     Country:  England    
Other Details:
Languages:  eng     Pagination:  1001-5     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Hennepin County Medical Center, 701 Park Ave., Mail Code 825, Minneapolis, MN, United States. eagross@comcast.net
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MeSH Terms
Descriptor/Qualifier:
Accidents, Traffic / prevention & control,  statistics & numerical data*
Adolescent
Adult
Alcoholic Intoxication / complications,  epidemiology
Arizona
Cohort Studies
Female
Humans
Indians, North American / statistics & numerical data*
Male
Middle Aged
Multiple Trauma / epidemiology*,  prevention & control
Retrospective Studies
Risk Factors
Seat Belts / utilization*
Social Environment*
Statistics as Topic
Utilization Review / statistics & numerical data

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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