Objective: To analyze the correlation between seat belt mark and the presence of visceral organ and musculoskeletal injuries in neck, thorax and/or abdomen. Setting. Level I Urban Trauma Center. Population: 1,264 patients involved in a car accident. Patients and method: We performed a retrospective study including all patients sustaining car accidents admitted to a Level I Urban Trauma Center over 14 months (July 2001-August 2002). Patients aged less than 16 years were excluded. The main outcome measure was the need for surgical intervention. Results: A total of 239 patients with seat belt mark were evaluated. The mean age was 39 years (range, 16-95, SD ± 17); 129 (53.9%) were males and 110 (46.1%) were females; 165 (69%) were drivers and 74 (31%) were passengers. The mean weight was 63 kg (range, 46-148 kg). One hundred and one sustained a seat belt mark over the abdomen with 31 associated injuries (30.6%); there were 86 seat belt marks over the thorax corresponding to 21 injuries (24.4%) and 24 seat belt marks over the neck without injuries. The most frequent injuries were thoracic-costal, clavicular and sternum fractures (including 8 myocardial contusions) and abdominal-mesenteric, small bowel, bladder, spleen, liver and colon injuries. Surgery was required by 73 (30.5%) of 239 patients with seat belt mark and by 85 of 564 patients (15%) without seat belt mark (p <0.01). Conclusion: The presence of seat belt marks over the thorax and/or abdomen were associated with a higher incidence of visceral organ and musculoskeletal injuries compared with the patients who sustained injuries without seat belt marks.
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