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Injury patterns and outcomes in motorcycle passengers

  • Original Article
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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction

Contemporary trauma literature on injuries to motorcycle passengers is scarce. The aim of this study was to examine the injury patterns and outcomes of motorcycle passengers with regard to helmet use. We hypothesized that helmet utilization affects both injury type and outcomes.

Methods

The National Trauma Data Bank was queried for all motorcycle passengers who were injured in traffic accidents. Participants were stratified according to helmet utilization into helmeted (HM) and nonhelmeted (NHM) groups. Univariate and multivariate analyses were performed to compare the injury patterns and outcomes between the groups.

Results

A total of 22,855 patients were included for analysis, of which 57.1% (13,049) used helmet. The median age was 41 years (IQR 26–51), 81% were female, and 16% of patients required urgent operation. NHM had higher risk of major trauma (ISS > 15: 26.8% vs 31.6%, p < 0.001). The most frequently injured body region in NHM was the head (34.6% vs 56.9%, p < 0.001), whereas in HM patients was the lower extremities (65.3% vs 56.7%, p < 0.001). NHM patients were more likely to require admission to the ICU, mechanical ventilation, and had significantly higher mortality rate (3.0% vs 6.3%, p < 0.001). The strongest predictors of mortality were GCS < 9 on admission, hypotension on admission, and severe head injury. Helmet utilization was associated with decreased odds of death (OR 0.636; 95% CI 0.531–0.762; p < 0.001).

Conclusion

Motorcycle collisions can lead to significant injury burden and high mortality in motorcycle passengers. Middle-age females are disproportionally affected. Traumatic brain injury is the leading cause of death. Helmet use is associated with decreased risk of head injury and death.

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Data availability

The data supporting this study is available through the National Trauma Databank as outlined in the Methods section of the manuscript.

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Authors and Affiliations

  1. 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

    Panagiotis Liasidis, Elizabeth Benjamin, Dominik Jakob, Meghan Lewis & Demetrios Demetriades

  2. Department of Surgery, Emory University, Grady Memorial Hospital, Glenn Memorial Building, 3rd Flr, 69 Jesse Hills Jr Dr SE, Atlanta, GA, 30303, USA

    Elizabeth Benjamin

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Contributions

PL, EB, and DD designed the study. PL and DJ performed the literature search and data collection. PL analyzed the data. All authors contributed to the interpretation of the data, writing of the manuscript, and approved the final version of the manuscript. ML, EB, and DD supervised all aspects of study design, data acquisition, analyses, and manuscript writing.

Corresponding author

Correspondence to Elizabeth Benjamin.

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Conflicts of interest

All authors declare no potential conflict of interest.

Ethics approval

This study was performed in line with the principles of the 1964 Helsinki Declaration and its later amendments. The Trauma Quality Improvement Program database contains de-identified data and a waiver of informed consent was obtained. The present study was approved by the Institutional Review Board of the University of Southern California.

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Liasidis, P., Benjamin, E., Jakob, D. et al. Injury patterns and outcomes in motorcycle passengers. Eur J Trauma Emerg Surg 49, 2447–2457 (2023). https://doi.org/10.1007/s00068-023-02296-8

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