Protective effect of helmet use on cervical injury in motorcycle crashes: A case–control study

Publication date: Available online 22 January 2019

Source: Injury

Author(s): Gwan-Jin Park, Jaeho Shin, Sang-Chul Kim, Dae-Seok Na, Hae-Ju Lee, Hoon Kim, Seok-Woo Lee, Yong-Nam In

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, 2,600 patients were analysed; among these, 1,145 (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.

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