Air Bags, Seat Belts Cut Hospital Costs, ICU Days

HOT SPRINGS, VA. — Greater use of air bag restraints in motor vehicle accidents may not only save lives and reduce the rates of most injuries and infectious complications, but also save trauma centers millions of dollars, according to a review of patients treated at a trauma center over an 11-year period.

Air bags were found to reduce injuries to all parts of the body except the extremities. If all unrestrained patients admitted to the trauma center had used seat belts and air bags, more than $14 million would have been saved in costs of treating infections, as well as almost $50 million in ICU stays.

Since the National Highway Transportation and Safety Administration mandated airbags for the front driver's side in 1989 and the front passenger side in 1998, “there has been a fair amount of controversy that's developed about their safety,” Dr. Timothy C. Fabian reported at the annual meeting of the Southern Surgical Association.

While most studies of motor vehicle accidents at the scene of the accident have found significantly lower odds of death with the use of seat belts alone or seat belts combined with air bags, some studies have shown only very modest or no benefit from air bags alone.

“All these studies are basically analyses of accidents at the scene. What we chose to do was look at patients admitted to a level I trauma center to see outcomes on those individuals,” said Dr. Fabian, chairman of the surgery department at the University of Tennessee Health Science Center, Memphis.

“It's sort of closing the loop to some degree … compared to previous studies,” said Dr. Fabian, who also is one of the founders of the Elvis Presley Memorial Trauma Center at the Regional Medical Center at Memphis.

In a study of 14,390 victims of motor vehicle accidents who were taken to the Presley Memorial Trauma Center during 1996–2006, investigators divided the patients into those who were unrestrained (7,881), used an air bag alone (692), used a seat belt alone (4,909), or used both seat belt and air bag (908).

Compared with unrestrained patients, injuries to several body regions (brain, face, cervical spine, and chest), but not the extremities, significantly decreased with the use of an air bag alone, a seat belt alone, or a seat belt and air bag combined. Injuries to the extremities significantly increased with the use of an air bag alone or in conjunction with a seat belt, but not with a seat belt alone. Abdominal injuries declined significantly only with use of an air bag alone or in combination with a seat belt.

Hospital mortality, as well as number of days in the ICU and hospital, declined significantly as the level of restraint increased.

The age of drivers and the percentage of drivers who were female increased with the level of protective restraints that were used, but the investigators adjusted all their analyses for these variables as well as the year of injury.

The percentages of patients who developed ventilator-associated pneumonia and bacteremia followed the same pattern as injuries and mortality, with significantly lower rates as the level of protection increased.

By using data from an analysis of the economic impact of infection control, Dr. Fabian and his associates determined that hospital costs increased by about $10,000 for each episode of ventilator-associated pneumonia and about $34,000 for each episode of bacteremia (Am. J. Infect. Control 2005;33:542–7). When these costs were indexed to 100 motor vehicle accident patients, the costs of providing care to unrestrained patients rose by nearly $300,000. The use of air bags and seat belts alone or in combination substantially decreased that amount.

Patients who used both seat belts and air bags were estimated to save about $60,000 in the cost of ICU stays, which were valued at about $35,000 per day.

During the 11-year study period, if all 7,881 unrestrained patients had used seat belts and air bags, the trauma center would have saved more than $14 million in infectious morbidity costs and about $47 million in ICU stays, according to Dr. Fabian and his colleagues.

Other studies have shown that air bags decrease deaths at the scene of an accident, which “probably does mean we have more patients coming to the trauma center,” said Dr. Regan F. Williams, one of Dr. Fabian's coinvestigators. “What we chose to really concentrate on [in this study] is once the patients got to the trauma center. So this in no way is supposed to be a population-based study.”

HOT SPRINGS, VA. — Greater use of air bag restraints in motor vehicle accidents may not only save lives and reduce the rates of most injuries and infectious complications, but also save trauma centers millions of dollars, according to a review of patients treated at a trauma center over an 11-year period.

Air bags were found to reduce injuries to all parts of the body except the extremities. If all unrestrained patients admitted to the trauma center had used seat belts and air bags, more than $14 million would have been saved in costs of treating infections, as well as almost $50 million in ICU stays.

Since the National Highway Transportation and Safety Administration mandated airbags for the front driver's side in 1989 and the front passenger side in 1998, “there has been a fair amount of controversy that's developed about their safety,” Dr. Timothy C. Fabian reported at the annual meeting of the Southern Surgical Association.

While most studies of motor vehicle accidents at the scene of the accident have found significantly lower odds of death with the use of seat belts alone or seat belts combined with air bags, some studies have shown only very modest or no benefit from air bags alone.

“All these studies are basically analyses of accidents at the scene. What we chose to do was look at patients admitted to a level I trauma center to see outcomes on those individuals,” said Dr. Fabian, chairman of the surgery department at the University of Tennessee Health Science Center, Memphis.

“It's sort of closing the loop to some degree … compared to previous studies,” said Dr. Fabian, who also is one of the founders of the Elvis Presley Memorial Trauma Center at the Regional Medical Center at Memphis.

In a study of 14,390 victims of motor vehicle accidents who were taken to the Presley Memorial Trauma Center during 1996–2006, investigators divided the patients into those who were unrestrained (7,881), used an air bag alone (692), used a seat belt alone (4,909), or used both seat belt and air bag (908).

Compared with unrestrained patients, injuries to several body regions (brain, face, cervical spine, and chest), but not the extremities, significantly decreased with the use of an air bag alone, a seat belt alone, or a seat belt and air bag combined. Injuries to the extremities significantly increased with the use of an air bag alone or in conjunction with a seat belt, but not with a seat belt alone. Abdominal injuries declined significantly only with use of an air bag alone or in combination with a seat belt.

Hospital mortality, as well as number of days in the ICU and hospital, declined significantly as the level of restraint increased.

The age of drivers and the percentage of drivers who were female increased with the level of protective restraints that were used, but the investigators adjusted all their analyses for these variables as well as the year of injury.

The percentages of patients who developed ventilator-associated pneumonia and bacteremia followed the same pattern as injuries and mortality, with significantly lower rates as the level of protection increased.

By using data from an analysis of the economic impact of infection control, Dr. Fabian and his associates determined that hospital costs increased by about $10,000 for each episode of ventilator-associated pneumonia and about $34,000 for each episode of bacteremia (Am. J. Infect. Control 2005;33:542–7). When these costs were indexed to 100 motor vehicle accident patients, the costs of providing care to unrestrained patients rose by nearly $300,000. The use of air bags and seat belts alone or in combination substantially decreased that amount.

Patients who used both seat belts and air bags were estimated to save about $60,000 in the cost of ICU stays, which were valued at about $35,000 per day.

During the 11-year study period, if all 7,881 unrestrained patients had used seat belts and air bags, the trauma center would have saved more than $14 million in infectious morbidity costs and about $47 million in ICU stays, according to Dr. Fabian and his colleagues.

Other studies have shown that air bags decrease deaths at the scene of an accident, which “probably does mean we have more patients coming to the trauma center,” said Dr. Regan F. Williams, one of Dr. Fabian's coinvestigators. “What we chose to really concentrate on [in this study] is once the patients got to the trauma center. So this in no way is supposed to be a population-based study.”

HOT SPRINGS, VA. — Greater use of air bag restraints in motor vehicle accidents may not only save lives and reduce the rates of most injuries and infectious complications, but also save trauma centers millions of dollars, according to a review of patients treated at a trauma center over an 11-year period.

Air bags were found to reduce injuries to all parts of the body except the extremities. If all unrestrained patients admitted to the trauma center had used seat belts and air bags, more than $14 million would have been saved in costs of treating infections, as well as almost $50 million in ICU stays.

Since the National Highway Transportation and Safety Administration mandated airbags for the front driver's side in 1989 and the front passenger side in 1998, “there has been a fair amount of controversy that's developed about their safety,” Dr. Timothy C. Fabian reported at the annual meeting of the Southern Surgical Association.

While most studies of motor vehicle accidents at the scene of the accident have found significantly lower odds of death with the use of seat belts alone or seat belts combined with air bags, some studies have shown only very modest or no benefit from air bags alone.

“All these studies are basically analyses of accidents at the scene. What we chose to do was look at patients admitted to a level I trauma center to see outcomes on those individuals,” said Dr. Fabian, chairman of the surgery department at the University of Tennessee Health Science Center, Memphis.

“It's sort of closing the loop to some degree … compared to previous studies,” said Dr. Fabian, who also is one of the founders of the Elvis Presley Memorial Trauma Center at the Regional Medical Center at Memphis.

In a study of 14,390 victims of motor vehicle accidents who were taken to the Presley Memorial Trauma Center during 1996–2006, investigators divided the patients into those who were unrestrained (7,881), used an air bag alone (692), used a seat belt alone (4,909), or used both seat belt and air bag (908).

Compared with unrestrained patients, injuries to several body regions (brain, face, cervical spine, and chest), but not the extremities, significantly decreased with the use of an air bag alone, a seat belt alone, or a seat belt and air bag combined. Injuries to the extremities significantly increased with the use of an air bag alone or in conjunction with a seat belt, but not with a seat belt alone. Abdominal injuries declined significantly only with use of an air bag alone or in combination with a seat belt.

Hospital mortality, as well as number of days in the ICU and hospital, declined significantly as the level of restraint increased.

The age of drivers and the percentage of drivers who were female increased with the level of protective restraints that were used, but the investigators adjusted all their analyses for these variables as well as the year of injury.

The percentages of patients who developed ventilator-associated pneumonia and bacteremia followed the same pattern as injuries and mortality, with significantly lower rates as the level of protection increased.

By using data from an analysis of the economic impact of infection control, Dr. Fabian and his associates determined that hospital costs increased by about $10,000 for each episode of ventilator-associated pneumonia and about $34,000 for each episode of bacteremia (Am. J. Infect. Control 2005;33:542–7). When these costs were indexed to 100 motor vehicle accident patients, the costs of providing care to unrestrained patients rose by nearly $300,000. The use of air bags and seat belts alone or in combination substantially decreased that amount.

Patients who used both seat belts and air bags were estimated to save about $60,000 in the cost of ICU stays, which were valued at about $35,000 per day.

During the 11-year study period, if all 7,881 unrestrained patients had used seat belts and air bags, the trauma center would have saved more than $14 million in infectious morbidity costs and about $47 million in ICU stays, according to Dr. Fabian and his colleagues.

Other studies have shown that air bags decrease deaths at the scene of an accident, which “probably does mean we have more patients coming to the trauma center,” said Dr. Regan F. Williams, one of Dr. Fabian's coinvestigators. “What we chose to really concentrate on [in this study] is once the patients got to the trauma center. So this in no way is supposed to be a population-based study.”