1
|
Giovannini E, Santelli S, Pelletti G, Bonasoni MP, Lacchè E, Pelotti S, Fais P. Motorcycle injuries: a systematic review for forensic evaluation. Int J Legal Med 2024:10.1007/s00414-024-03250-y. [PMID: 38763926 DOI: 10.1007/s00414-024-03250-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/05/2024] [Indexed: 05/21/2024]
Abstract
The intricate interplay of exposure and speed leave motorcyclists vulnerable, leading to high mortality rates. During the collision, the driver and the passenger are usually projected away from the motorcycle, with variable trajectories or final positions. Injuries resulting from the crash can exhibit distinct and specific characteristics depending on the circumstances of the occurrence.The aim of this study is to provide a systematic review of the literature on injuries sustained by motorcyclists involved in road accidents describing and analyzing elements that are useful for forensic assessment.The literature search was performed using PubMed, Scopus and Web of Science from January 1970 to June 2023. Eligible studies have investigated issues of interest to forensic medicine about during traffic accidents involving motorcycle. A total of 142 studies met the inclusion criteria and were classified and analyzed based on the anatomical regions of the body affected (head, neck, thoraco-abdominal, pelvis, and limb injuries). Moreover, also the strategies for preventing lesions and assessing injuries in the reconstruction of motorcycle accidents were examined and discussed.This review highlights that, beyond injuries commonly associated with motorcycle accidents, such as head injuries, there are also unique lesions linked to the specific dynamics of accidents. These include factors like the seating position of the passenger or impact with the helmet or motorbike components. The forensic assessment of injury distribution could serve as support in reconstructing the sequence of events leading to the crash and defining the cause of death in trauma fatalities.
Collapse
Affiliation(s)
- Elena Giovannini
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy
| | - Simone Santelli
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy
| | - Guido Pelletti
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy.
| | - Maria Paola Bonasoni
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia, 42122, Italy
| | - Elena Lacchè
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy
| | - Susi Pelotti
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy
| | - Paolo Fais
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy
| |
Collapse
|
2
|
Rauer T, Klingebiel FKL, Lühring A, Küffer A, Hofer AS, Ferrari RM, Kupka M, Pape HC. Cranio-cervical and traumatic brain injury patterns-do they differ between electric bicycle, bicycle, and motorcycle-induced accidents? Eur J Trauma Emerg Surg 2024:10.1007/s00068-024-02510-1. [PMID: 38592466 DOI: 10.1007/s00068-024-02510-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/28/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE With the growing technical options of power transmission and energy-saving options in electric drives, the number of E-bike-related accidents especially in an elderly population has increased. The aim of the current study was to compare if the increased velocity in comparison to conventional bikes translates into different injury patterns in the cranio-cervical and head region. METHODS A retrospective cohort study was performed in patients admitted to our level one trauma center between 2009 and 2019 after being involved in an accident with either an E-bike, bicycle, or motorcycle and suffered cranio-cervical or traumatic brain injury. OUTCOMES cranio-cervical/intracranial injury pattern. Data interpretation was conducted in an interdisciplinary approach. RESULTS From 3292 patients treated in this period, we included 1068 patients. E-bikers were significantly older than bicyclists (or motorcyclists) and lay between the other two groups in terms of helmet use. Overall injury patterns of E-bikers resembled those found in motorcyclists rather than in bicyclists. E-bikers had a higher incidence of different cerebral bleedings, especially if no helmet was worn. Helmet protection of E-bikers resulted in a comparable frequency of intracranial bleeding to the helmeted bicyclists. CONCLUSION The overall pattern of head and cervical injuries in E-bikers resembles more to that of motorcyclists than that of bicyclists. As they are used by a more senior population, multiple risk factors apply in terms of complications and secondary intracranial bleeding. Our study suggests that preventive measures should be reinforced, i.e., use of helmets to prevent from intracranial injury.
Collapse
Affiliation(s)
- Thomas Rauer
- Department of Trauma Surgery, University Hospital Zurich, 8091, Zurich, Switzerland.
| | - Felix Karl-Ludwig Klingebiel
- Department of Trauma Surgery, University Hospital Zurich, 8091, Zurich, Switzerland
- Department of Surgical Research, Harald Tscherne Laboratory for Orthopaedic and Trauma Research, Zurich University Hospital, Zurich, Switzerland
| | - Adrian Lühring
- Department of Trauma Surgery, University Hospital Zurich, 8091, Zurich, Switzerland
- Medical University of Innsbruck, 6020, Innsbruck, Austria
| | - Alexander Küffer
- Department of Neurosurgery, University Hospital Zurich, 8091, Zurich, Switzerland
| | - Anna-Sophie Hofer
- Department of Neurosurgery, University Hospital Zurich, 8091, Zurich, Switzerland
- Department of Neurosurgery, Medical University Innsbruck, 6020, Innsbruck, Austria
| | - Raphael Marco Ferrari
- Department of Cranio-Maxillo-Facial and Oral Surgery, University Hospital Zurich, 8091, Zurich, Switzerland
| | - Michael Kupka
- Department of Neuroradiology, University Hospital Zurich, 8091, Zurich, Switzerland
| | - Hans-Christoph Pape
- Department of Trauma Surgery, University Hospital Zurich, 8091, Zurich, Switzerland
- Department of Surgical Research, Harald Tscherne Laboratory for Orthopaedic and Trauma Research, Zurich University Hospital, Zurich, Switzerland
| |
Collapse
|
3
|
Brockhus LA, Liasidis P, Lewis M, Jakob DA, Demetriades D. Injury patterns and outcomes in motorcycle driver crashes in the United States: The effect of helmet use. Injury 2024; 55:111196. [PMID: 38030451 DOI: 10.1016/j.injury.2023.111196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Motorcycle crashes pose a persistent public health problem with disproportionate rates of severe injuries and mortality. This study aims to analyze injury patterns and outcomes with regard to helmet use. We hypothesized that helmet use is associated with fewer head injuries and does not increase the risk of cervical spine injuries. METHODS The National Trauma Data Bank was queried for all motorcycle driver crashes between 2007-2017. Univariable analysis was used to compare demographics, clinical data, injury patterns using abbreviated injury scale, and outcomes between helmeted motorcycle drivers and non-helmeted motorcycle drivers who were injured in traffic crashes. Independent factors associated with mortality were determined by regression analysis after adjustment for potential confounders. RESULTS A total of 315,258 patients were included for analysis, 66 % of these patients were helmeted. The sample was 92.5 % male and the median age was 41 years. Non-helmeted motorcycle drivers were more likely to sustain severe head trauma (head abbreviated injury scale ≥ 3: 28.5 % vs. 13.3 %, p < 0.001), had higher intensive care unit-admission (38 % vs. 30.2 %, p<0.001), mechanical ventilation (20.1 % vs. 13 %, p<0.001) and overall mortality rates (6.2 % vs. 3.9 %, p<0.001). Cervical spine injuries occurred in 10.6 % of non-helmeted motorcycle drivers and in 9.5 % of helmeted motorcycle drivers (p<0.001). Helmet use was identified as an independent factor associated with lower mortality [OR 0.849 (0.809-0.891), p<0.001]. CONCLUSION Helmet use is protective for severe head injuries and associated with decreased mortality. Helmet use was not associated with increased rates of cervical spine injuries. On the contrary, fewer injuries were observed in helmeted motorcycle drivers. Public health initiatives should be aimed at enforcement of universal helmet laws within the United States and across the world.
Collapse
Affiliation(s)
- Lara A Brockhus
- Department of Emergency Medicine, Inselspital, Bern University Hospital, Bern University, Bern, Switzerland
| | - Panagiotis Liasidis
- Division of Trauma and Surgical Critical Care, Department of Surgery, Los Angeles County and University of Southern California Medical Center, University of Southern California, Los Angeles, CA, USA
| | - Meghan Lewis
- Division of Trauma and Surgical Critical Care, Department of Surgery, Los Angeles County and University of Southern California Medical Center, University of Southern California, Los Angeles, CA, USA
| | - Dominik A Jakob
- Department of Emergency Medicine, Inselspital, Bern University Hospital, Bern University, Bern, Switzerland; Division of Trauma and Surgical Critical Care, Department of Surgery, Los Angeles County and University of Southern California Medical Center, University of Southern California, Los Angeles, CA, USA.
| | - Demetrios Demetriades
- Division of Trauma and Surgical Critical Care, Department of Surgery, Los Angeles County and University of Southern California Medical Center, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
4
|
Haizel-Cobbina J, Thakkar R, Still M, Shlobin NA, Izah J, Du L, Shamim MS, Bonfield CM, Gepp R, Dewan MC. Global Epidemiology of Pediatric Traumatic Spine Injury: A Systematic Review and Meta-Analysis. World Neurosurg 2023; 178:172-180.e3. [PMID: 37473863 DOI: 10.1016/j.wneu.2023.07.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE Traumatic spine injury (TSI) leads to significant morbidity and mortality in children. However, the global epidemiology of pediatric TSI is currently unknown. We conducted a systematic review and meta-analysis to estimate the global incidence of pediatric TSI and the burden of cases. METHODS PubMed, Embase, and Scopus were searched for reports in June 2021 and updated in March 2023 with no restrictions on language or year of publication. A meta-analysis was conducted to estimate the global incidence of pediatric TSI and, subsequently, the number of cases of pediatric TSI worldwide and the proportion requiring spine surgery. RESULTS Of 6557 studies, 25 met the inclusion criteria. Road traffic accidents (64%) were responsible for most cases reported in the literature, followed by falls (18%). The global incidence of TSI in children aged ≤20 years was estimated to be 14.24 of 100,000 children, or 375,734 children, with an estimated 114,975 requiring spine surgery. Across the World Bank income classification groups, lower middle-income countries had the highest pediatric TSI case burden (186,886 cases, with 57,187 requiring spine surgery). Across the World Health Organization regions, countries in the Southeast Asia region had the largest number of projected cases at 88,566, with 27,101 requiring surgical management, followed closely by the African region, with 87,235 projected cases and 26,694 requiring surgical management. CONCLUSIONS Pediatric TSI represents a large healthcare burden globally. Interventions targeting both injury prevention and strengthening of neurosurgical capacity, especially in low resource settings, are needed to address this global health challenge.
Collapse
Affiliation(s)
- Joseline Haizel-Cobbina
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Rut Thakkar
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Megan Still
- Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Nathan A Shlobin
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Justine Izah
- Meharry Medical College, Nashville, Tennessee, USA
| | - Liping Du
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - M Shahzad Shamim
- Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Christopher M Bonfield
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ricardo Gepp
- Department of Neurosurgery, SARAH Network of Rehabilitation Hospitals, Brasília, Brazil
| | - Michael C Dewan
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
| |
Collapse
|
5
|
Liu YH, Wiratama BS, Chao CJ, Wang MH, Chen RS, Saleh W, Pai CW. Unhelmeted Riding, Drunk Riding, and Unlicensed Riding among Motorcyclists: A Population Study in Taiwan during 2011-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1412. [PMID: 36674166 PMCID: PMC9864229 DOI: 10.3390/ijerph20021412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
This study aimed to investigate the association between drunk riding, unhelmeted riding, unlicensed riding, and running-off-road (ROR) crashes. Multiple logistic regression was used to calculate the adjusted odds ratio (AOR) by using the National Taiwan Traffic Crash Dataset for 2011-2016. The results revealed that unhelmeted riding was associated with 138% (AOR = 2.38; CI (confidence interval) = 2.34-2.42) and 47% (AOR = 1.47; CI = 1.45-1.49) higher risks of drunk riding and unlicensed riding, respectively. The risk of unhelmeted riding increased with blood alcohol concentrations (BACs), and riders with the minimum BAC (0.031-0.05%) had nearly five times (AOR = 4.99; CI = 4.74-5.26) higher odds of unlicensed riding compared with those of riders with a negative BAC. Unhelmeted riding, drunk riding, and unlicensed riding were associated with 1.21 times (AOR = 1.21; CI = 1.13-1.30), 2.38 times (AOR = 2.38; CI = 2.20-2.57), and 1.13 times (AOR = 1.13; CI = 1.06-1.21) higher odds of ROR crashes, respectively. The three risky riding behaviours (i.e., unhelmeted riding, drunk riding, and unlicensed riding) were significantly related to ROR crashes. The risk of unhelmeted riding and ROR crashes increased with BACs.
Collapse
Affiliation(s)
- Yen-Hsiu Liu
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 110, Taiwan
| | - Bayu Satria Wiratama
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 110, Taiwan
- Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City 55281, Indonesia
| | - Chung-Jen Chao
- Department of Traffic Science, Central Police University, Taoyuan 333, Taiwan
| | - Ming-Heng Wang
- Department of Traffic Management, Taiwan Police College, Taipei 116, Taiwan
| | - Rui-Sheng Chen
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 110, Taiwan
- 2nd District Headquarters, Yongji Station, Fire Department of Taipei City, Taipei 110, Taiwan
| | - Wafaa Saleh
- Transport Research Institute, Edinburgh Napier University, Edinburgh EH11 4DY, UK
| | - Chih-Wei Pai
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 110, Taiwan
| |
Collapse
|
6
|
Hasjim BJ, Grigorian A, Schubl SD, Lekawa M, Kim D, Bernal N, Nahmias J. Helmets Protect Pediatric Bicyclists From Head Injury and Do Not Increase Risk of Cervical Spine Injury. Pediatr Emerg Care 2022; 38:e360-e364. [PMID: 33181791 DOI: 10.1097/pec.0000000000002290] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Only 21 states have mandatory helmet laws for pediatric bicyclists. This study sought to determine the incidence of helmeted riders among pediatric bicyclists involved in a collision and hypothesized the risk of a serious head and cervical spine injuries to be higher in nonhelmeted bicyclists (NHBs) compared with helmeted bicyclists (HBs). METHODS The Pediatric Trauma Quality Improvement Program (2014-2016) was queried for pediatric (age <16 years) bicyclists involved in a collision. Helmeted bicyclists were compared with NHBs. A serious injury was defined by an abbreviated injury scale grade of greater than 2. RESULTS From 3693 bicyclists, 3039 (82.3%) were NHBs. Compared with HBs, NHBs were more often Black (21.6% vs 3.8%, P < 0.001), Hispanic (17.5% vs 9.3%, P < 0.001), without insurance (4.6% vs 2.4%, P = 0.012), and had a higher rate of a serious head injury (24.6% vs 9.3%, P < 0.001). Both groups had similar rates of complications and mortality (P > 0.05). The associated risk of a serious head (odds ratio = 3.17, P < 0.001) and spine injury (odds ratio = 0.41, P = 0.012) were higher and lower respectively in NHBs. Associated risks for cervical spine fracture or cord injury were similar (P > 0.05). CONCLUSIONS Pediatric bicyclists involved in a collision infrequently wear helmets, and NHBs was associated with higher risks of serious head injury. However, the associated risk of serious spine injury among NHBs was lower. The associated risks for cervical spine fracture or cervical cord injuries were similar. Nonhelmeted bicyclists were more likely to lack insurance and to be Black or Hispanic. Targeted outreach programs may help decrease the risk of injury, especially in at-risk demographics.
Collapse
Affiliation(s)
- Bima J Hasjim
- From the Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine
| | - Areg Grigorian
- From the Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine
| | - Sebastian D Schubl
- From the Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine
| | - Michael Lekawa
- From the Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine
| | - Dennis Kim
- Division of Trauma/Acute Care Surgery/Surgical Critical Care, LA County Harbor-UCLA Medical Center, Torrance, CA
| | - Nicole Bernal
- From the Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine
| | - Jeffry Nahmias
- From the Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine
| |
Collapse
|
7
|
Alghamdi A, Alqahtani A. Magnetic Resonance Imaging of the Cervical Spine: Frequency of Abnormal Findings with Relation to Age. MEDICINES 2021; 8:medicines8120077. [PMID: 34940289 PMCID: PMC8708021 DOI: 10.3390/medicines8120077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/07/2021] [Accepted: 12/10/2021] [Indexed: 12/11/2022]
Abstract
Background: Patients with neck pain are frequently encountered in cervical spine (C-spine) magnetic resonance imaging (MRI) practice. However, the exact distribution and prevalence of cervical abnormalities are not known. Aim: The aim of this study is to evaluate the association between age, gender, and prevalence of abnormal cervical MRI findings. Methods: Records of 111 cervical MRIs were collected in 12 months from January to December 2019 from adults aged 20–89 years who were referred from neurosurgery, neurology, and orthopedic clinics. Findings were classified and analyzed using the Statistical Package for Social Science (SPSS), version 24.0 (IBM, Armonk, NY, USA). The chi-square test was used to determine the association between demographics and abnormalities using a significance of p = 0.05. Results: The majority of patients were female (72.1%). The number of abnormal incidences increased with age until it reached a peak at ages 50–59. Spondylodegenerative changes were the most frequent finding, which was present in 52.2% of the total sample, and was followed by disc bulge (25.2%). Incidences increased in lower discs, with C5–C6 being the most frequent in 65% of the total sample. Younger males in their 20s had more injuries than females of the same age. However, this rate was reversed in patients over 40, as women were the dominant gender among patients in their 40s with cervical injuries, with a rate of 81.5%. Conclusion: In our study, we found that older patients developed more C-spine injuries. Gender may play a role in the rate of incidents. However, we did not find any significant differences between men and women or between different types of abnormalities.
Collapse
Affiliation(s)
- Ali Alghamdi
- Department of Radiological Sciences, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia
- Correspondence:
| | - Abeer Alqahtani
- Department of Radiology, King Fahad Hospital, Albaha 65515, Saudi Arabia;
| |
Collapse
|
8
|
Barron S, Falank C, Ontengco J, Chung B, Carter DW. Severity and patterns of injury in helmeted vs. non-helmeted motorcyclists in a rural state. JOURNAL OF SAFETY RESEARCH 2021; 77:212-216. [PMID: 34092311 DOI: 10.1016/j.jsr.2021.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/22/2020] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Under current law in our rural state, there is no universal requirement for motorcyclists to wear helmets. Roughly 500 motorcycle crashes are reported by the state each year and only a fraction of those riders wear helmets. We sought to determine the difference in injury patterns and severity in helmeted versus non-helmeted riders. METHODS Retrospective review (2014-2018) of a single level 1 trauma center's registry was done for subjects admitted after a motorcycle collision. Demographic, injury and patient outcome data were collected. Patients were stratified by helmet use (n = 81), no helmet use (n = 144), and unknown helmet use (n = 194). Statistical analysis used Student's t-test or Pearson's χ2p-value ≤0.05 as significant. State Department of Transportation data registry for state level mortality and collision incidence over the same time period was also obtained. RESULTS Of the 2,022 state-reported motorcycle collisions, 419 individuals admitted to our trauma center were analyzed (21% capture). State-reported field fatality rate regardless of helmet use was 4%. Our inpatient mortality rate was 2% with no differences between helmet uses. Helmeted riders were found to have significantly fewer head and face injuries, higher GCS, lower face, neck, thorax and abdomen AIS, fewer required mechanical ventilation, shorter ICU length of stay, and had a greater number of upper extremity injuries and higher upper extremity AIS. CONCLUSIONS Helmeted motorcyclists have fewer head, face, and cervical spine injuries, and lower injury severities: GCS and face, neck, thorax, abdomen AIS. Helmeted riders had significantly less mechanical ventilation requirement and shorter ICU stays. Non-helmeted riders sustained worse injuries. Practical Applications: Helmets provide safety and motorcycle riders have a 34-fold higher risk of death following a crash. Evaluating injury severities and patterns in motorcycle crash victims in a rural state with no helmet laws may provide insight into changing current legislation.
Collapse
Affiliation(s)
- Sivana Barron
- Tufts University School of Medicine, 136 Harrison Ave, Boston, MA 02111, USA.
| | - Carolyne Falank
- Department of Surgery, Maine Medical Center, Portland, ME 04102, USA.
| | - Julianne Ontengco
- Department of Surgery, Maine Medical Center, Portland, ME 04102, USA.
| | - Bruce Chung
- Department of Surgery, Maine Medical Center, Portland, ME 04102, USA.
| | - Damien W Carter
- Department of Surgery, Maine Medical Center, Portland, ME 04102, USA.
| |
Collapse
|
9
|
Flowers S, Schott S, Flanigan N, Palepu S, Osier NN. Clinician guide to motorcycle helmet safety. Int J Inj Contr Saf Promot 2021; 28:392-399. [PMID: 34027792 DOI: 10.1080/17457300.2021.1928232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Motorcyclists' increased likelihood of involvement in motor vehicle collisions increases their risk of brain injury or death. Despite irrefutable evidence of the protective capabilities of motorcycle helmets, their use among riders is not ubiquitous. This paper is a functional guide to motorcycle helmet safety, assisting clinicians in promoting helmet use and treating patients with motorcycle-related injuries. First, five commonly held myths that promote unhelmeted riding are dispelled. Then, clinicians are prepared to assist their patients in choosing an appropriate helmet through an in-depth presentation of motorcycle helmet construction, testing, and sizing. Discussion of patient care considerations for first responders, emergency medicine practitioners, and primary care providers will empower all-level clinicians to act as patient advocates. Finally, ethical and legal considerations regarding motorcycle helmet use are clarified. Equipping clinicians with applicable knowledge of motorcycle helmet safety will translate to safer roads and fewer motorcyclist patients.
Collapse
Affiliation(s)
- Shannon Flowers
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Sophie Schott
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | | | - Sriram Palepu
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Nicole Nico Osier
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA.,School of Nursing, The University of Texas, Austin, TX, USA
| |
Collapse
|
10
|
Medina O, Singla V, Liu C, Fukunaga D, Rolfe K. Patterns of spinal cord injury in automobiles versus motorcycles and bicycles. Spinal Cord Ser Cases 2020; 6:75. [PMID: 32820149 DOI: 10.1038/s41394-020-00324-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 11/09/2022] Open
Abstract
STUDY DESIGN Retrospective case series. OBJECTIVES To examine the patterns and relative rates of occurrence of spinal cord injury (SCI) in automobiles compared to motorcycles and bicycles. SETTING Los Angeles County, California. METHODS A retrospective chart review of SCI consults at Rancho Los Amigos National Rehabilitation Center in Los Angeles County, California between 2003 and 2013 were selected and screened for a mechanism of injury involving a vehicular accident. Chart review was performed to determine neurological levels and extent of impairment, which were graded according to the International Standards for Neurological Classification of Spinal Cord Injury. RESULTS We identified 398 cases of SCI from 2003 to 2013 that fit the inclusion criteria. Overall, the relative percentages of ASIA impairment scale (AIS) A/B/C/D did not differ statistically across automobiles, motorcycles, or bicycles. When stratified by spinal region, motorcycles had a higher percentage of thoracic SCIs compared to automobiles. Automobiles resulted in more cervical SCIs with few injuries in the lumbar region. Bicycle patterns followed automobiles, not motorcycles. Thoracic SCIs were more likely graded motor complete than cervical or lumbar injuries, regardless of the mechanism. CONCLUSIONS Automobile, motorcycle, and bicycle related SCIs occur primarily in the cervicothoracic region. SCIs due to motorcycle accidents have a higher predilection for the thoracic region, and there is a statistically higher percentage of motor complete injuries. A higher percentage of cervical SCIs occur as a result of automobile and bicycle accidents. Extrapolations from motor vehicle usage data suggest that the relative rate of occurrence of SCI for motorcycles is higher than for automobiles.
Collapse
Affiliation(s)
- Omar Medina
- Department of Orthopaedic Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Varun Singla
- Department of Orthopaedic Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA.
| | - Charles Liu
- Department of Neurosurgery and Orthopedic Surgery, Rancho Los Amigos National Rehabilitation Center, Downey, CA, USA
| | - Dudley Fukunaga
- Department of Neurosurgery and Orthopedic Surgery, Rancho Los Amigos National Rehabilitation Center, Downey, CA, USA
| | - Kevin Rolfe
- Department of Orthopaedic Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA.,Department of Neurosurgery and Orthopedic Surgery, Rancho Los Amigos National Rehabilitation Center, Downey, CA, USA
| |
Collapse
|
11
|
Effect of motorcycle helmet types on head injuries: evidence from eight level-I trauma centres in Taiwan. BMC Public Health 2020; 20:78. [PMID: 31952485 PMCID: PMC6969422 DOI: 10.1186/s12889-020-8191-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/09/2020] [Indexed: 11/24/2022] Open
Abstract
Background Motorcycle full-coverage helmet use may reduce fatalities and head injuries. Methods This retrospective cohort study extracted injury data from eight level-I trauma centres in Taiwan and performed a questionnaire survey to investigate injuries sustained by motorcyclists for the period between January 2015 and June 2017. Results As many as 725 patients participated in the questionnaire survey and reported their helmet types or phone use during crashes. The results of multivariate logistic models demonstrated that nonstandard helmet (half or open-face helmet) use was associated with an increased risk of head injuries and more severe injuries (injury severity score ≥ 8). Drunk riding and phone use appeared to be two important risk factors for head injuries and increased injury severity. Anaemia was also found to be a determinant of head injuries.” Conclusions Compared to full-coverage helmets, nonstandard provide less protection against head injuries and increased injury severity among motorcyclists.
Collapse
|
12
|
Park GJ, Shin J, Kim SC, Na DS, Lee HJ, Kim H, Lee SW, In YN. Protective effect of helmet use on cervical injury in motorcycle crashes: A case-control study. Injury 2019; 50:657-662. [PMID: 30765183 DOI: 10.1016/j.injury.2019.01.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Helmet use during motorcycle crashes (MCCs) has been shown to reduce traumatic brain injury and mortality. However, preventive effects of its use on cervical spine injury remain controversial. In this study, we evaluated whether helmet use can reduce cervical spine injury during MCCs. PATIENTS AND METHODS A case-control study using data from the Emergency Department-based Injury In-depth Surveillance (EDIIS) registry was conducted. Cases were defined as patients with cervical spine injury [≥2 points in the Abbreviated Injury Scale (AIS)] in MCCs from 2011 to 2016. Four controls were matched to one case with strata which included age and sex from the EDIIS registry. Primary outcome was cervical spine injury, secondary outcome was intensive care unit (ICU) admission, and tertiary outcomes was mortality. Multivariable logistic regression analysis was used to calculate odds ratios (OR) with 95% confidence intervals (CIs) to evaluate the associations between helmet use and related outcomes. RESULTS In total, 2600 patients were analysed; among these, 1145 (44.0%) used helmets at the time of crashes. The helmet group showed lower alcohol consumption and mortality rates than the no helmet group (alcohol: 3.2% vs. 9.2%, respectively, and mortality: 2.4% vs. 7.1%, respectively; p < 0.01). Compared with the no helmet group, the helmet group was less likely to have cervical spine injury [adjusted OR, 0.62 (0.51-0.77)]. In addition, helmet use has been shown to help prevent ICU admission and mortality [adjusted OR, 0.45 (0.36-0.56) and 0.32 (0.21-0.51), respectively]. CONCLUSION Helmet use was found to have significant preventive effects on cervical spine injury during MCCs.
Collapse
Affiliation(s)
- Gwan-Jin Park
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Jaeho Shin
- School of Mechanical and Automotive Engineering, Kyungil University, South Korea.
| | - Sang-Chul Kim
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Dae-Seok Na
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Hae-Ju Lee
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Hoon Kim
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Seok-Woo Lee
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Yong-Nam In
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| |
Collapse
|