Preventive effects of car safety seat use on clinical outcomes in infants and young children with road traffic injuries: A 7-year observational study

Abstract

IntroductionRoad traffic injury (RTI) is one of the major mechanisms of injury leading to high disability and case-fatality in infants and children. Proper car safety seat use can reduce fatal outcomes in pediatric patients with RTI; however, the use rate is still low. This study aimed to measure the preventive effects of car safety seat use on clinical outcomes among infants and young children injured from RTI. MethodsA multicenter cross-sectional study was conducted using the Emergency Department-based Injury In-depth Surveillance (EDIIS) registry from 23 EDs between Jan 2010 and Dec 2016. All pediatric patients who were under 6 years of age and who sustained RTI in a vehicle with fewer than 10-seats were eligible. Primary and secondary endpoints were intracranial injury and mortality. We calculated the adjusted odds ratio (AOR) of the car safety seat for related outcomes adjusting for potential confounders. ResultsAmong 5545 eligible patients, 1452 (26.2%) patients were in car safety seats at the time of the crash (12.5% in 2010 to 33.9% in 2016, p-for-trend <0.01), and 104 (1.9%) patients had intracranial injuries. The patients using car safety seats were less likely to have intracranial injuries compared with the patients not using car safety seats (0.8% vs. 2.2%, AOR: 0.31 (0.17–0.57)). However, there was no significant difference in mortality between the two groups (0.4% vs. 0.6%, AOR: 0.50 (0.20–1.25)). ConclusionUse of the car safety seat has significant preventive effects on intracranial injury. Public health efforts to increase use of car safety seats for infants and young children are needed to reduce the burden of RTI.