Munk Marc-David, Carboneau Dora M, Hardan Muhammed, Ali Faleh Mohamed
University of Pittsburgh, Department of Emergency Medicine, 230 McKee Place, Suite 500, Pittsburgh, PA 15213, USA.
Prehosp Disaster Med. 2008 Nov-Dec;23(6):547-52. doi: 10.1017/s1049023x00006397.
Road traffic crashes (RTCs) are common in Qatar, and are now considered the third leading cause of mortality. In this study, the safety devices used by the Qatari public at the time of RTCs were assessed and the association between seatbelt use by vehicle occupants involved in RTCs and severe injury/death in the prehospital setting was determined.
This study was a retrospective case-control investigation. A Hamad Medical Corporation Emergency Medical Services (EMS) database of RTCs occurring from January 2006 to April 2007 was utilized for this study, providing a total of 5,267 patient records (83.5% male, 16.5% female, median age = 28 years). Patient demographics, crash characteristics, prehospital assessments, and interventions were identified, and use of safety devices was determined. Univariate analysis including chi-square, Student's t-test, and analysis of variance (ANOVA) was performed as appropriate. "Case" patients are defined as those who had specific, critical prehospital assessments, or who received advanced cardio-respiratory life support measures in the field. Logistic regression modeling was used to predict the probability of a case being unbelted, controlling for confounders.
Seatbelt use in Qatar was low: 33.9% of males and 32.6% of females wore seatbelts at the time of the RTC. Victims involved in a vehicle rollover crash were less likely to be belted than were those involved in a non-rollover incident (26.2% belted vs. 37.8%; OR = 0.59; 95% CI = 0.50-0.68). Case patients-those with defined critical assessment findings or resuscitation in the field-and control patients were similar in age (30 years vs. 28 years median). Case patients were disproportionately male (89.1% vs. 83.2%; OR = 1.65; 95% CI = 1.01-2.83) and were more likely to be victims of a vehicle rollover crash (44.7% vs. 23.8%; OR = 2.57; 95% CI = 1.84-3.59). Seatbelt use was significantly lower among cases than controls: 19.7% of cases were reported to have worn seatbelts compared to 34.2% of controls (OR = 0.47; 95% CI = 0.31-0.69). This relationship also persisted (OR = 0.51; 95% CI = 0.33-0.76) after controlling for confounders.
Seatbelt use in Qatar is low. Seatbelts are protective: in the prehospital setting unbelted vehicle occupants involved in RTCs were nearly twice as likely to suffer severe injury or death compared to belted patients. Prehospital morbidity and mortality appears to be reduced significantly by the consistent use of seatbelts by the motoring population in Qatar.
道路交通事故（RTCs）在卡塔尔很常见，目前被认为是第三大死亡原因。在本研究中，评估了卡塔尔公众在道路交通事故发生时使用的安全装置，并确定了道路交通事故中车内乘客使用安全带与院前环境下重伤/死亡之间的关联。
本研究是一项回顾性病例对照调查。本研究使用了哈马德医疗公司紧急医疗服务（EMS）数据库中2006年1月至2007年4月发生的道路交通事故记录，共提供了5267份患者记录（男性占83.5%，女性占16.5%，中位年龄 = 28岁）。确定了患者的人口统计学特征、事故特征、院前评估和干预措施，并确定了安全装置的使用情况。根据情况进行了包括卡方检验、学生t检验和方差分析（ANOVA）在内的单变量分析。“病例”患者定义为那些进行了特定的、关键的院前评估，或在现场接受了高级心肺生命支持措施的患者。使用逻辑回归模型预测病例未系安全带的概率，并对混杂因素进行控制。
卡塔尔的安全带使用率较低：在道路交通事故发生时，33.9%的男性和32.6%的女性系了安全带。与未发生翻车事故的受害者相比，发生车辆翻车事故的受害者系安全带的可能性较小（26.2%系安全带 vs. 37.8%；OR = 0.59；95% CI = 0.50 - 0.68）。病例患者（即那些有明确关键评估结果或在现场进行复苏的患者）和对照患者的年龄相似（中位年龄分别为30岁和28岁）。病例患者中男性比例过高（89.1% vs. 83.2%；OR = 1.65；95% CI = 1.01 - 2.83），并且更有可能是车辆翻车事故的受害者（44.7% vs. 23.8%；OR = 2.57；95% CI = 1.84 - 3.59）。病例组的安全带使用率明显低于对照组：据报告，19.7%的病例系了安全带，而对照组为34.2%（OR = 0.47；95% CI = 0.31 - 0.69）。在控制混杂因素后，这种关系仍然存在（OR = 0.51；95% CI = 0.33 - 0.76）。
卡塔尔的安全带使用率较低。安全带具有保护作用：在院前环境中，与系安全带的患者相比，道路交通事故中未系安全带的车内乘客遭受重伤或死亡的可能性几乎是其两倍。卡塔尔驾车人群持续使用安全带似乎可显著降低院前发病率和死亡率。
