Association between helmets and facial injury after a motorcycle collision: an analysis of more than 40 000 patients from the National Trauma Data Bank.
ABSTRACT Motorcycle collisions are increasing at a precipitous rate, and reliable and valid data regarding all aspects of helmet safety are needed to better inform ongoing debates on mandatory helmet laws. The objective of this study was to determine the effect of motorcycle helmets on the likelihood of a facial injury after motorcycle collisions, using data from the National Trauma Data Bank, version 7.0, on 46 362 patients from January 1, 2002, through December 31, 2006. Multiple logistic regression was used to analyze the independent association between helmets and facial injury with adjustment for potential confounders. Helmeted motorcyclists were less likely to suffer facial injuries after a motorcycle collision, with a lower adjusted odds ratio of facial injury (0.40; 95% CI, 0.37-0.43) and a lower prevalence of specific types of facial injury compared with their nonhelmeted counterparts.
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ABSTRACT: The effectiveness of helmets in reducing the risk of severe head injury in motorcyclists who were involved in a crash is well established. There is limited evidence however, regarding the extent to which helmets protect riders from facial injuries. The objective of this study was to determine the effect of helmet type, components and fixation status on the risk of facial injuries among Malaysian motorcyclists.BMC Emergency Medicine 08/2014; 14(1):17. DOI:10.1186/1471-227X-14-17
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ABSTRACT: The natural history and epidemiological aspects of traumatic vertebral artery dissection (VAD) are not fully understood. We determined the prevalence of VAD and impact on outcome of patients with head and neck trauma. All the patients who were admitted with traumatic brain injury or head and neck trauma were identified by ICD-9-CM codes from the National Trauma Data Bank (NTDB), using data files from 2009 to 2010. NTDB represents one of the largest trauma databases and contains data from over 900 trauma centers across the United States. Presence of VAD was identified in these patients by using ICD-9-CM codes. Admission Glasgow Coma Scale (GCS) score, injury severity score (ISS), in-hospital complications, and treatment outcome were compared between patients with and without VAD. A total of 84 VAD patients were identified which comprised 0.01 % of all patients admitted with head and neck trauma. The mean age (in years) for patients with VAD was significantly higher than patients without dissection [46 (95 % CI 41-50) vs. 41.3 (95 % CI 41.2-41.4); p = 0.003]. The proportion of patients presenting with GCS score <9 was significantly higher in patients with VAD (31 vs. 12 %, p < 0.0001). The rate of cervical vertebral fracture was significantly higher in patients with VAD (71 vs. 11 %, p < 0.0001). Patients with VAD had higher rates of in-hospital stroke than patients without dissection (5 vs. 0.2 %, p < 0.0001). Numbers of ICU days, ventilator days, and hospital length of stays were all significantly higher in patients with VAD. These differences remained significant after adjusting for the demographics, admission GCS score, and ISS (p < 0.0001). A total of 7 % (N = 6) of the patients with VAD received endovascular treatment and there was no in-hospital stroke in these patients. Patients with VAD had a higher chance of discharge to nursing facilities in comparison to head trauma patients without VAD (OR: 2.1; 95 % CI 1.4-3.5; p < 0.0001). Although infrequent, VAD in head and neck trauma is associated with higher rates of in-hospital stroke and longer length of ICU stay and total hospital stay. Early diagnosis and endovascular treatment may be an alternative option to reduce the rate of in-hospital stroke in these patients.Neurocritical Care 02/2014; 21(2). DOI:10.1007/s12028-013-9937-8 · 2.60 Impact Factor
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ABSTRACT: The occurrence of road traffic accidents and severe crash injuries involving commercial motorcyclist has risen significantly in recent times in Nigeria. Human factors, vehicular conditions and the state of Nigeri an roads are some of the reasons that have been adduced for this increase. Three hundred commercial motorcyclists in Sagamu , South West, Nigeria were recruited into the study. Wit h the aid of structured interviewer administered questionnaire s, the risk related behavio urs of motorcyclists were studied as it relates to the occurrence of road traffic crashes. A ll respondents were males, mostly young people , who had no formal training prior to riding. Three percent (3%) of the respondents use d crash helmet whereas, 62.7% take alcohol during work hours and 34.7% smoke cigarette. There was a high prevalence of high risk behaviour for road traffic accidents and severe crash injuries among the respondents due to a lack of safety consciousness and non - enforcement of regulations prohibiting high risk behaviours . A concerted effort should be made to create a safety consciousness among commercial motorcyclists while e nsuring strict enforcement of regulation concerning training before licensing and use of protective devices. Prohibition of psychoactive substance use during work hours is hereby recommended.