Abstract
Background: Currently, less than half of all U.S. states require helmets for motorcycle
operators. Although research has demonstrated the effectiveness of helmets, less is
known about the characteristics of individuals who choose to ride motorcycles unhelmeted.
Objectives: The specific aims of this study were to identify risk factors leading
to riding and crashing a motorcycle without a helmet and to compare outcomes of helmeted
vs. unhelmeted motorcyclists involved in a motorcycle crash. Methods: This 13-year
(1994–2006) retrospective study of adult motorcycle crashes admitted to a Level II
trauma center compares helmeted to unhelmeted motorcyclists. Results: There were 1738
motorcyclists admitted, including 978 (56%) helmeted (38 years old, 87% male) and
760 (44%) unhelmeted (38 years old, 85% male). Unhelmeted riders had a higher Injury
Severity Score (16 vs. 13, p < 0.001), lower Glasgow Coma Scale score (13 vs. 14, p < 0.001), and more hypotension (6% vs. 4%, p = 0.03). Unhelmeted riders had worse outcomes, including higher rate of severe disability
(16% vs. 10%, p < 0.001), more days in the hospital (7 vs. 6, p < 0.001) and intensive care unit (2 vs. 1, p < 0.001), incurred higher hospital charges ($44,744 vs. $31,369, p < 0.001), and had higher mortality (6% vs. 2%, p < 0.001). Independent predictors of riding without a helmet included alcohol intoxication,
riding as a passenger, and lack of health insurance. Conclusions: Unhelmeted motorcyclists
sustain more severe injuries and adverse outcomes. Motorcyclists who are intoxicated,
uninsured, or passengers are less likely to wear a helmet. Education and prevention
strategies should be targeted at these high-risk populations.
Keywords
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Article info
Publication history
Published online: September 27, 2009
Accepted:
July 23,
2009
Received in revised form:
July 13,
2009
Received:
January 20,
2009
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
