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Comparative Study
. 2014 Oct;192(4):1131-6.
doi: 10.1016/j.juro.2014.04.093. Epub 2014 May 17.

The impact of seat belts and airbags on high grade renal injuries and nephrectomy rate in motor vehicle collisions

Marc A Bjurlin  1 , Richard Jacob Fantus  2 , Richard Joseph Fantus  3 , Michele M Mellett  4 , Dana Villines  5
Affiliations
Comparative Study

The impact of seat belts and airbags on high grade renal injuries and nephrectomy rate in motor vehicle collisions

Marc A Bjurlin et al. J Urol. 2014 Oct.

Abstract

Purpose: Motor vehicle collisions are the most common cause of blunt genitourinary trauma. We compared renal injuries with no protective device to those with seat belts and/or airbags using NTDB. Our primary end point was a decrease in high grade (grades III-V) renal injuries with a secondary end point of a nephrectomy rate reduction.

Materials and methods: The NTDB research data sets for hospital admission years 2010, 2011 and 2012 were queried for motor vehicle collision occupants with renal injury. Subjects were stratified by protective device and airbag deployment. The AIS was converted to AAST renal injury grade and nephrectomy rates were evaluated. Intergroup comparisons were analyzed for renal injury grades, nephrectomy, length of stay and mortality using the chi-square test or 1-way ANOVA. The relative risk reduction of protective devices was determined.

Results: A review of 466,028 motor vehicle collisions revealed a total of 3,846 renal injuries. Injured occupants without a protective device had a higher rate of high grade renal injuries (45.1%) than those with seat belts (39.9%, p = 0.008), airbags (42.3%, p = 0.317) and seat belts plus airbags (34.7%, p <0.001). Seat belts (20.0%), airbags (10.5%) and seat belts plus airbags (13.3%, each p <0.001) decreased the nephrectomy rate compared to no protective device (56.2%). The combination of seatbelts and airbags also decreased total hospital length of stay (p <0.001) and intensive care unit days (p = 0.005). The relative risk reductions of high grade renal injuries (23.1%) and nephrectomy (39.9%) were highest for combined protective devices.

Conclusions: Occupants of motor vehicle collisions with protective devices show decreased rates of high grade renal injury and nephrectomy. Reduction appears most pronounced with the combination of seat belts and airbags.

Keywords: accidents; kidney; nephrectomy; seat belts; traffic; wounds and injuries.

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Figures

Figure 1
Figure 1. High-grade renal injury rate by protective device
Comparisons represent each protective device group in comparison to the no protective device group. The seatbelt group and seatbelt+airbag had lower rates of high-grade renal injury than the no protective device group (p = 0.008 and <0.001, respectively) while the airbag group's rate of injury did not differ statistically from the no protective device group (= 0.317).
Figure 2
Figure 2. Nephrectomy rate of high-grade renal injury by protective device
Comparisons represent each protective device group in comparison to the no protective device group. All protective device groups had lower rates of nephrectomy than the no protective device group (p < 0.001 for all comparisons).
See this image and copyright information in PMC

References

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