Introduction Motor vehicle crashes (MVC) are the leading cause of morbidity and mortality across the globe. Seat belt is an important protective device which improves occupant’s safety during MVC. Herein, we aimed to evaluate the impact of protective devices used (seatbelt/airbag) on the injury pattern and outcome of vehicle occupants involved in MVC.

Methods It is a retrospective analysis of all trauma patients who sustained MVC-related injuries and need admission in Qatar between 2011 and 2014.

Results Of the total 2730 MVC, 1830 (67%) cases sustained MVC-related injuries; majority was young males (87.7%) and two-third was expatriates. Fifty five percent of the victims were drivers; only 26.3% used seat belt and airbag was found in 2.5% cases. Higher proportion of unbelted passengers were nationals, younger in age, and had higher incidence head, chest and upper extremities injuries than belted passengers (P = 0.001). Belted passengers sustained more bowl (P = 0.001) and lower extremities injuries (P = 0.01). Unbelted passengers sustained higher injury severity (ISS, GCS and chest AIS), stayed longer in the hospital and had higher rate of pneumonia and mortality compared to belted patients (P = 0.001). Compliance of seatbelt (P = 0.001) and air bag (P = 0.008) was significantly lower in the ejected group. Also, ejected patients had prolonged hospital stay and developed significantly higher proportion of pneumonia and sepsis (P = 0.001). The overall mortality was 8.3% and three fold higher in the ejected group as compared to non-ejected group (18% vs. 6.3%; P = 0.001).

Conclusion Use of protective devices improves occupant’s safety and potentially prevents ejection during MVCs. Our study highlighted a lower rate of seatbelt compliance among young population which resulted in severe injuries, greater need of hospital resources and mortality. Therefore, community education, strict rules and more attention for legislative implementation are need focusing high-risk groups.