This press release upsets me so. You see my 3rd son wants to get a motor cycle. “Not while you live in my house” is my mantra…. but I do know that I can only sing that song for so long. And so I wring my hands and will continue to print out these press releases in the hope that some modicum of sense will prevail.
Patients with traumatic brain injuries (TBIs) associated with motorcycle accidents were found to have a high probability of long-term disability and were significantly more likely to die in the hospital than were patients without TBIs.
Age-specific helmet laws were found to be less effective than universal helmet laws and were associated with an increased incidence of death and traumatic brain injury in the population that they were supposed to protect
Almost a third of young motorcycle riders who have a crash sustain a traumatic brain injury, researchers reported.
Once injured, they are more than 10 times as likely to die in the hospital as riders who have other forms of trauma, according to Harold Weiss, PhD, of the University of Pittsburgh, and colleagues.
And the problem is worse in states that have age-specific helmet laws but do not require all riders to wear head protection, Weiss and colleagues reported in two companion papers online in Pediatrics.
The researchers reported two studies:
* An examination of traumatic brain injuries in 2006 among motorcycle riders ages 12 through 20, using the Kids’ Inpatient Database to derive national estimates.
* A comparison of the rates of traumatic brain injuries in the same age group between states with a universal helmet law and those that mandate head protection only for specific ages, using 2005, 2006, and 2007 data from the State Inpatient Databases of the Healthcare Cost and Utilization Project.
In the first study, they found there were an estimated 5,662 discharges in 2006 related to motorcycle crashes. Of those, 31.7% involved a traumatic brain injury — some 1,793 patients.
On average, the analysis revealed that those with traumatic brain injury:
* Had a longer hospital stay — 6.4 days versus 4.1. The difference was significant at P<0.001.
* Had a higher injury severity score — 41.1 versus 8.2. Again, the difference was significant at P<0.001.
* Were less likely to be discharged home (75.6% versus 86.4%) and more likely to be sent to another type of facility (12.1% compared with 3.3%).
* Were more likely to die in hospital – 4.2% versus 0.4%.
* The disposition data were significantly different between the groups at P<0.0001.
As well, Weiss and colleagues said, the cases involving brain injury were significantly more likely (at P<0.0001) to have occurred in traffic, rather than off-road.
In the second study, the researchers explored the idea that age-specific helmet laws are as effective as universal laws. If that were the case, they argued, there should be no difference in traumatic brain injuries among young riders between states with different laws.
Over the three-year study period, they reported, 20 states and the District of Columbia had laws requiring all riders to wear a helmet, 27 had age-specific laws, and three had no law.
All told, the analysis included 9,287 motorcycle injury discharges among riders ages 12 through 20.
Of those, Weiss and colleagues found, in universal helmet states 30.9% of 4,602 cases involved a traumatic brain injury, compared with 37.8% of 2,313 cases in states where those younger than 18 were required to wear a helmet, and 32.1% of 1,916 cases where the law required those under 21 to wear a helmet.
When the principal diagnosis was intracranial injury, they reported, the rates were significantly different among the groups, at P<0.05: 16.2% for universal helmet states, 20.2% for under-18 states, and 18% for under-21 states.
The risk of a serious or severe injury was significantly higher in partial-law states, compared with universal-law states, they reported: The odds ratio was 1.37, with a 95% confidence interval from 1.23 to 1.54, which was significant at P<0.001.
The implication, they concluded is that age-specific helmet laws are associated with an increased risk of traumatic brain injury among young riders, compared with universal laws.
The incidence study, Weiss and colleagues noted, may underestimate the risk of traumatic brain injury, largely because of a lack of exposure data. The helmet study is an ecological analysis, they cautioned, and the discharge data did not include data on helmet use. As well, they noted, it may have residual confounding.
The studies were supported by the National Highway Traffic Safety Administration. The researchers said they had no relevant financial conflicts.
Primary source: Pediatrics
Source reference:
Weiss H, et al “Youth motorcycle-related hospitalizations and traumatic brain injuries in the United States in 2006” Pediatrics 2010; 126: 1141-1148.
Additional source: Pediatrics
Source reference:
Weiss H, et al “Youth motorcycle-related brain injury by state helmet law type: United States, 2005-2007” Pediatrics 2010; 126: e1589-e1595.
