Research Reports - More helmets fewer deaths: Motorcycle helmet legislation impacts traumatic brain injury-related mortality in young adults

Am Surg. 2017 Jun 1;83(6):541-546.

Hassan A, Jokar TO, Rhee P, Ibraheem K, Kulvatunyou N, Anderson KT, Gries L,
Roward ZT, Joseph B.

The aim of our study was to assess the impact of helmet legislations on the
incidence and the mortality rate of motorcycle collision (MCC)-related traumatic
brain injury (TBI) in young adult trauma patients. A 1-year (2011) retrospective
analysis was performed of all patients under 21 years old with trauma-related
hospitalization using the Nationwide Inpatient Sample database (representing 20%
of all in-patient admissions). Patients with MCC were identified using E-codes.
States were classified into three groups based on helmet legislations: universal
age helmet legislation, <18 years helmet legislation, and <21 years helmet
legislation. Outcome measures were the rates of TBI and mortality. Linear
regression analysis was used to assess outcomes among the states. A total of
1,165,150 patients with trauma-related hospitalizations across 29 states were
reviewed of which, 587 patients with MCC were included. Ten states had universal
age legislation; 13 states had age <18 years legislation, and 6 states had age
<21 years legislation. There was a lower incidence in the rate of TBI (P = 0.03)
in states with universal helmet legislations compared with states with
age-restricted helmet legislation. Universal helmet legislations lowered the rate
of MCC-related TBI injures by a factor of 2.15 (β coefficient: 2.15; 95%
confidence interval: 0.91-10.18; P = 0.04). States with age-restricted helmet
legislations have a higher rate of traumatic brain injury and mortality compared
with states with universal helmet legislations. Establishing universal helmet
legislations across the states may provide a potential preventive strategy
against traumatic brain injury. 

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