Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Department of Emergency Medicine, University of Virginia, Charlottesville, Virginia.
Traffic Inj Prev. 2022;23(8):494-499. doi: 10.1080/15389588.2022.2113782. Epub 2022 Aug 29.
As obesity rates climb, it is important to study its effects on motor vehicle safety due to differences in restraint interaction and biomechanics. Previous studies have shown that an abdominal seatbelt sign (referred hereafter as seatbelt sign) sustained from motor vehicle crashes (MVCs) is associated with abdominal trauma when located above the anterior superior iliac spine (ASIS). This study investigates whether placement of the lap belt causing a seatbelt sign is associated with abdominal organ injury in occupants with increased body mass index (BMI). We hypothesized that higher BMI would be associated with a higher incidence of superior placement of the lap belt to the ASIS level, and a higher incidence of abdominal organ injury.
A retrospective data analysis was performed using 230 cases that met inclusion criteria (belted occupant in a frontal collision that sustained at least one abdominal injury) from the Crash Injury Research and Engineering Network (CIREN) database. Computed tomography (CT) scans were rendered to visualize fat stranding to determine the presence of a seatbelt sign. 146 positive seatbelt signs were visualized. ASIS level was measured by adjusting the transverse slice of the CT to the visualized ASIS level, which was used to determine seatbelt sign location as superior, on, or inferior to the ASIS.
Obese occupants had a significantly higher incidence of superior belt placement (52%) vs on-ASIS placement (24%) compared to their normal (27% vs 67%) BMI counterparts (p < 0.001). Notable trends included obese occupants with superior placement having less abdominal organ injury incidence than those with on-ASIS belt placement (42% superior placement vs 55% on-ASIS). In non-obese occupants, there was a higher incidence of abdominal organ injury with superior lap belt placement compared to on-ASIS placement counterparts (Normal BMI: 62% vs 41%, Overweight: 57% vs 43%).
In CIREN occupants with abdominal injury, those with obesity are more prone to positioning the lap belt superior to the ASIS, though the impact on abdominal injury incidence remains a key point for continued exploration into how occupant BMI affects crash safety and belt design.
随着肥胖率的攀升，研究肥胖对机动车安全的影响变得尤为重要，因为肥胖人群的约束装置相互作用和生物力学均有所不同。既往研究表明，机动车碰撞（MVC）后遗留的腹部安全带征（简称安全带征）位于髂前上棘（ASIS）上方时与腹部创伤相关。本研究旨在探讨在体重指数（BMI）较高的患者中，安全带征的出现是否与腹部器官损伤相关。我们假设较高的 BMI 与安全带在 ASIS 上方较高位置的发生率相关，与腹部器官损伤的发生率相关。
采用 Crash Injury Research and Engineering Network（CIREN）数据库中 230 例符合纳入标准（正面碰撞中系安全带的患者至少存在一处腹部损伤）的患者进行回顾性数据分析。对 CT 扫描进行渲染，以显示脂肪错置，从而确定安全带征的存在。可视化了 146 个阳性安全带征。通过调整 CT 横切片以适应可视化的 ASIS 水平，来测量 ASIS 水平，从而确定安全带征的位置是位于 ASIS 上方、ASIS 上或 ASIS 下方。
与正常 BMI（27% vs 67%）患者相比，肥胖患者的安全带明显更易位于 ASIS 上方（52%），而非 ASIS 上（24%）（p<0.001）。值得注意的趋势包括：ASIS 上方安全带的肥胖患者的腹部器官损伤发生率低于 ASIS 上安全带的患者（42% vs 55%）。而非肥胖患者中，与 ASIS 上安全带相比，ASIS 上方安全带与更高的腹部器官损伤发生率相关（正常 BMI：62% vs 41%，超重：57% vs 43%）。
在 CIREN 伴有腹部损伤的患者中，肥胖患者更倾向于将安全带置于 ASIS 上方，尽管肥胖对腹部损伤发生率的影响仍然是一个关键点，需要进一步探讨 BMI 如何影响碰撞安全性和安全带设计。
