Outcomes of Road Traffic Accidents Before and After the Implementation of a Seat Belt Detection System: A Comparative Retrospective Study in Riyadh

Abstract

Introduction Road traffic accidents (RTAs) are considered a major cause of death in Saudi Arabia. As seat belt compliance provides significant safety among drivers, a camera detection system has been implemented in March 2018 to enforce seat belt utilization, which can decrease the severity of road traffic injuries. There are no previous studies in the country that have assessed the effectiveness of a seat belt camera detection system on the severity of RTA-related injuries. Methods A retrospective cohort study was conducted at King Abdulaziz Medical Trauma Center in Riyadh, Saudi Arabia. The study included 688 adult patients who were involved in RTAs from the period of March 2016 to March 2020. A data extraction form included sociodemographics, clinical variables, and outcome measures. The data were analyzed using Statistical Analysis Software (SAS) to evaluate the primary outcome measures: mortality, ejection from the vehicle, ICU admissions, and severity measures (injury severity score (ISS) and Glasgow Coma Scale (GCS)) before and after the implementation of seat belt detection system. Associations of the outcome measures in the pre-implementation and the post-implementation periods' seat belt detection were assessed using regression tests. Results There was no significant difference in the mean age between the pre-implementation and post-implementation periods of the seat belt detection system (31.39 years and 32.57 years, respectively). All of the outcome measures have improved following the implementation of the seat belt detection system. Mortality and ejection rates decreased significantly with 58% lower risk of death (OR= 0.42; 95% CI= 0.2,0.8) and 37% lower risk of ejection (OR= 0.63; 95% CI= 0.42,0.94). ICU admissions showed a slight decline in the post-implementation period compared to the pre-implementation period (30.37% vs. 31.37, p<0.7764). Severity measures (ISS and GCS) were slightly improved in the post-implementation period. Head and neck injuries were dominant in the pre-implementation period, and chest injuries were the most common body injuries after the implementation. Conclusion This study highlights the direct association between compliance with seat belt use and the primary outcome measures among patients who survived a road traffic accident. All of the outcome measures showed improvement in the post-implementation period, which indicates the effectiveness of the newly implemented seat belt detection system. These findings raise awareness to the public in regard to seat belt compliance.