Seatbelt effectiveness and cost of noncompliance among drivers admitted to a trauma center.

Enactment of seatbelt legislation in Maryland presented the opportunity to compare seatbelt compliance among seriously injured drivers admitted to a Level I trauma center and to establish levels of severity, length of stay, and hospital cost differences among the study population. Fifty-five randomly selected drivers were examined from a total surgical population of 689. Seatbelt compliance rate was 41.8%, reflecting the rate in the community. Seatbelts reduced the total number of injuries by 34%, major injuries by 57%, and minor injuries by 20%. No deaths occurred among the belted group. The unbelted group had a mean Injury Severity Score two times as great as the belted group and were hospitalized 1.6 times longer at double the cost. Major injuries to the face, chest, and pelvic regions were prevented by the seatbelt. Among the belted group, severe injuries did occur to the head, neck, and abdominal regions. It is recommended that both air bags and automatic restraining devices be required for all drivers if the trauma occurring daily on highways is to be eliminated and acute hospital cost minimized.