The following is a summary of “Prevalence of intra-abdominal injury among patients with seatbelt signs, a systematic review and meta-analysis,” published in the February 2024 issue of Emergency Medicine by Pourmand, et al.

The evolution of seat belts has been crucial in decreasing morbidity and mortality from motor vehicle collisions (MVCs). The “seat belt sign” (SBS) is a vital physical examination finding that has informed management decisions for many years. For a study that included a systematic review and random-effects meta-analysis, researchers sought to evaluate the existing literature regarding the association between SBS and intra-abdominal injury and the need for surgical intervention.

They searched the PubMed and Scopus databases from their inception to August 4, 2023, to identify eligible studies. The outcomes of interest were the prevalence of intra-abdominal injury and the requirement for surgical intervention. They assessed the risk of bias and study quality using Cochrane’s Risk of Bias (RoB) tool and the Newcastle-Ottawa Scale (NOS), respectively. Heterogeneity was evaluated using Q-statistics and I² values.

The search identified nine observational studies involving 3,050 patients, among whom 1937 (63.5%) exhibited a positive SBS. The pooled prevalence of any intra-abdominal injury was 0.42 (95% CI 0.28–0.58, I² = 96%). The presence of an SBS was significantly associated with increased odds of intra-abdominal injury (OR 3.62, 95% CI 1.12–11.6, P = 0.03; I² = 89%) and a higher likelihood of surgical intervention (OR 7.34, 95% CI 2.03–26.54, P < 0.001; I² = 29%). However, there was considerable heterogeneity in the measurement of any intra-abdominal injury (I² = 89%).

The meta-analysis indicated that the presence of an SBS was linked to a significantly higher likelihood of intra-abdominal injury and the need for surgical intervention. However, the study exhibited high heterogeneity, likely attributed to technological advancements such as seat belt design and diagnostic imaging sensitivity over the study period. Additional studies utilizing more recent data were warranted to validate the findings.

Reference: sciencedirect.com/science/article/abs/pii/S0735675723006721