Injury severity in relation to seatbelt usage in Cape Town : a pilot study
Article based on this thesis is available at http://hdl.handle.net/10019.1/98154
Thesis (MMed)--Stellenbosch University, 2015.
ENGLISH SUMMARY : Introduction: Injuries and death from road traffic accidents present an enormous challenge to the South African health care system and creates a significant societal and economic burden in the country. The use of seatbelts and child restraints is one of the most important actions that can be taken to prevent injury in a road traffic accident. Objectives: This pilot study attempted to determine seatbelt prevalence in the Cape Town Metropole and compare injury severity to seatbelt usage. Methods: A prospective cohort design was used. All occupants involved in road traffic accidents in the Cape Town Metropole attended to by EMS Metro Rescue were included during the three month data collection period. Patients, who were admitted, were followed up and injury severity scores calculated using the Injury Severity Score. Disposition from the emergency centre and follow up after one week was compared between restrained and unrestrained occupants. A 5% level of confidence was used to determine whether differences were statistically significant and odds ratios with corresponding 95% confidence intervals were calculated as relative measure of association. Results: A total of 107 patients were included in the pre-hospital phase. The prevalence of seatbelt usage was found to be 25.23% while only 8.3% of rear seat occupants (n = 24) were restrained. A statistically significant association was shown between seatbelt non-use and higher triage category (p=0.006; Odds Ratio (OR) = 5.39, 95% Confidence Interval (CI) 1.49 to 19.47). Trends also suggest associations between seatbelt non-use and young male occupants, as well as early morning and late night driving. A total of 50 patients were followed up during the hospital phase. There was no significant association between seatbelt usage and injury severity, yet all fatalities and seriously injured patients (Injury Severity Score >15) were unrestrained (p=0.29; OR = 0.38, 95%CI 0.019 to 7.588). Unrestrained occupants were also more likely to be admitted (p=0.002). Discussion: Seatbelt prevalence in occupants involved in road traffic accidents was much lower than national and provincial statistical claims. The strong association between seatbelt non-use and road traffic deaths and severe injuries necessitate stricter enforcement of current seatbelt and child restraint laws to improve seatbelt compliance. The information gained from this study could assist with future research projects to possible determine causes of high risk behaviour. It will potentially aid authorities to develop and implement strategies to improve road safety.
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