The objective of this study was to compare the injuries and outcomes of ejected victims who reached a Level I trauma center with nonejected MVC occupants.
Data from 6,909 MVC victims admitted to a Level I trauma center, over a 91/2-year period, were retrospectively reviewed. Three mutually exclusive groups were studied: ejected, nonejected nonrestrained, and nonejected restrained.
The patient distribution was as follows: ejected 6.4% (n = 443), nonrestrained 50.1% (n = 3,461), and restrained 43.5% (n = 3,005). Ejected patients were younger, required ICU care more frequently, and a higher percentage were males compared with nonrestrained or restrained patients. Injury Severity Score (ISS) and length of stay (LOS) were significantly higher in ejected patients. Ejected patients suffered more injuries per anatomic region, and had a higher number of severe injuries in the head and neck region. The overall in-hospital mortality was 3.9% (272/6,909), and 10.8% (48/443) for the ejected group. The incidence of restrained patients increased during the study period but was not associated with a change in the incidence of ejected patients.
Patients who were ejected after motor vehicle collisions were more severely injured and had a worse outcome than those not ejected. Efforts should be concentrated on enforcement and enactment of better seat belt laws, as well as the development of new strategies that will prevent ejection regardless of occupant behavior.
From the Department of Surgery, Burns/Trauma Section (E.G., J.A.A., D.S.Y.W., K.B., K.J., M.H.J.), and the Department of Computers and Statistics (K.J.), Washington Hospital Center, Washington, DC, and the Department of Surgery, Uniformed University of the Health Sciences (J.A.A., D.S.Y.W., M.H.J.), Bethesda, Maryland.
Submitted for publication October 29, 2000.
Accepted for publication July 6, 2001.
Poster presentation at the 60th Annual Meeting of the American Association for the Surgery of Trauma, October 11–15, 2000, San Antonio, Texas.
Address for reprints: José A. Acosta, MD, FACS, Puerto Rico Trauma Center, Medical Center Administration, P.O. Box 2129, San Juan, Puerto Rico 00922-2190.