The Impact of Protective Devices Across the Spectrum of Trauma Care and Across Racial Groupings

Introduction Protective devices such as seat belts and helmets save lives. Most studies only address one aspect of the injury profile – compliance or mortality – not the entire spectrum of trauma care, and little attention is paid to racial differences in the use or impact of protective devices. Methods Patients with blunt mechanisms where using protective devices would be expected were included and were divided into utilizing (P) vs not utilizing protection (Non-P). Chart review included demographics, injuries sustained, hemodynamics, and blood alcohol level. Outcomes included need for emergent operation, complications and death. Results Non-P patients were more likely male, presented at night and intoxicated. Highest risk behavior (intoxicated Non-P) presented at night (25.7% of nighttime presentations), and rarely during daytime (6.7% daytime presentations). Non-P were more likely hypotensive and sustain a traumatic brain injury. No race related differences were noted among young patients. Among older (>/=50 years) patients, White patients were least likely Non-P and least likely presented at night. Non-P required more emergent operative intervention, ICU admission, and longer hospital stay. Overall, Non-P was associated with increased risk of death (OR = 1.6 (95% CI = 1.28 – 2.11). Conclusion Given unique age and racial differences, we advocate for culturally and age specific public service campaigns.