Repeal of Universal Helmet Laws: Do Motorcycle Helmet Laws Affect the Incidence of Craniomaxillofacial Trauma?
Nicholas S. Adams, MD1, Patrick A. Newbury, BS2, John A. Girotto, MD, MMA3.
1Michigan State University College of Human Medicine/GRMEP, Grand Rapids, MI, USA, 2Michigan State University College of Human Medicine, Grand Rapids, MI, USA, 3Helen DeVos Children's Hospital, Grand Rapids, MI, USA.
Purpose: Motorcycle helmet legislation has been a contentious topic of debate for over a half-century. On April 13, 2012 the state of Michigan repealed a 35-year-old universal motorcycle helmet law in favor of a partial helmet law. Loss of motorcycle tourism dollars was cited as the major motivating factor. We describe the early clinical effects on craniomaxillofacial trauma and mortality at a level-1 trauma center in West Michigan.
Methods: Motorcycle trauma patients presenting to a level-1 trauma center 3 years before and after the law repeal (n=534) were included in a retrospective cohort study.
Results: Following repeal, the rates of non-helmeted trauma patients increased from 7% to 30%. Overall rates of facial fractures increased from 13.2% to 14.6%, although this did not reach statistical significance. Crash-scene mortality of non-helmeted patients increased dramatically from 6.7% to 61% and motorcyclists admitted to the hospital were over twice as likely to require ventilator support. No difference was observed with respect to total length of stay (LOS), ICU LOS, Injury Severity Score (ISS) or Glasgow Coma Scale (GCS). Compared to helmeted motorcyclists, non-helmeted patients were twice as likely to sustain facial fractures and had double the rate of hospital mortality. Patients with facial fractures were nearly five times more likely to die following admission compared to those without.
Conclusion: This study highlights the significant negative impact of relaxed motorcycle helmet laws. While craniomaxillofacial trauma trended towards a statistical significant increase, helmet use and crash-scene mortality dramatically increased.
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