Can helmet decrease mortality of craniocerebral trauma patients in a motorcycle accident?: A propensity score matching

Autoři: Woo Sung Choi aff001;  Jin-Seong Cho aff002;  Yeon Sik Jang aff001;  Yong Su Lim aff002;  Hyuk Jun Yang aff002;  Jae-Hyug Woo aff002
Působiště autorů: Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea aff001;  Department of Emergency Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea aff002
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article


A helmet is critical for preventing head injuries during motorcycle accidents. However, South Korean motorcyclists have a lower prevalence of wearing a helmet, compared to developed countries. Therefore, we aimed to evaluate whether helmet wearing was associated with the clinical outcomes in Korean motorcycle accidents. Data were obtained from the Emergency Department-based Injury In-depth Surveillance database 2011–2015. We considered the patients had experienced a motorcycle accident and were only diagnosed with a craniocerebral trauma (CCT). The primary outcome was mortality and the secondary outcomes were the severity and hospitalization duration. The patients were separated whether they were wearing a helmet and the outcomes were compared using multivariate logistic regression after propensity score matching (PSM). Among 1,254,250 patients in the database, 2,549 patients were included. After PSM, 1,016 patients in each group were matched. The univariate analyses revealed that helmet wearing was associated with lesser severity (P < 0.001) and shorter hospitalization (P < 0.001). The regression analysis revealed that mortality was also lower in a helmet-wearing group (odds ratio: 0.34, 95% confidence interval: 0.21–0.56). In conclusion, wearing a helmet may reduce the mortality from a CCT after a motorcycle accident and associated with lesser severity and shorter hospitalization.

Klíčová slova:

Alcohol consumption – Ambulances – Critical care and emergency medicine – Death rates – Health insurance – Hospitals – Patients – Schools


1. Korean National Police Agency. Traffic Acident Chart 2011–2015 [cited on 14 October 2019].

2. National Highway Traffic Safety Administration. Traffic Safety Factors. 2006. [cited 14 October 2019].

3. World Health Organization. Helmets: a road safety manual for decision-makers and practitioners. 2006 [cited 14 October 2019].

4. Keng SH. Helmet use and motorcycle fatalities in Taiwan. Accident; Analysis and Prevention. 2005;37(2):349–55. doi: 10.1016/j.aap.2004.09.006 15667822.

5. Byrnes M, Gerberich S. Motorcycle helmet use and legislation: a systematic review of the literature. Minnesota Medicine. 2012;95(1):60–5. 22355917.

6. Cha MI, Kim GW, Kim CH, Choa M, Choi DH, Kim I, et al. A study on the disaster medical response during the Mauna Ocean Resort gymnasium collapse. Clinical and experimental emergency mededicine. 2016;3(3):165–74. doi: 10.15441/ceem.15.106 27752635.

7. Kim J, Shin SD, Im TH, Kug Jong L, Ko SB, Park JO, et al. Development and validation of the Excess Mortality Ratio-adjusted Injury Severity Score Using the International Classification of Diseases 10th Edition. Academic emergency medicine. 2009;16(5):454–64. doi: 10.1111/j.1553-2712.2009.00412.x 19388920.

8. Tsai YJ, Wang JD, Huang WF. Case-control study of the effectiveness of different types of helmets for the prevention of head injuries among motorcycle riders in Taipei, Taiwan. American Journal of epidemiology. 1995;142(9):974–81. doi: 10.1093/oxfordjournals.aje.a117746 7572979.

9. Shankar V, Mannering F. An exploratory multinomial logit analysis of single-vehicle motorcycle accident severity. Journal of Safety Research. 1996;27(3):183–94.

10. Richter M, Otte D, Lehmann U, Chinn B, Schuller E, Doyle D, et al. Head injury mechanisms in helmet-protected motorcyclists: prospective multicenter study. The Journal of trauma. 2001;51(5):949–58. doi: 10.1097/00005373-200111000-00021 11706346.

11. Jou RC, Yeh TH, Chen RS. Risk factors in motorcyclist fatalities in Taiwan. Traffic Injury Prevention. 2012;13(2):155–62. doi: 10.1080/15389588.2011.641166 22458794.

12. Dutra VdC, Caregnato RCA, Figueiredo MRB, Schneider DdS. Craniocerebral trauma in motorcyclists: relation of helmet use and trauma severity. Acta Paulista de Enfermagem. 2014;27:485–91.

13. Chenier TC, Evans L. Motorcyclist fatalities and the repeal of mandatory helmet wearing laws. Accident; analysis and prevention. 1987;19(2):133–9. doi: 10.1016/0001-4575(87)90032-7 3580090.

14. Sosin DM, Sacks JJ. Motorcycle helmet-use laws and head injury prevention. JAMA. 1992;267(12):1649–51. 1542175.

15. Kraus JF, Peek C, Williams A. Compliance with the 1992 California motorcycle helmet use law. American journal of Public Health. 1995;85(1):96–9. doi: 10.2105/ajph.85.1.96 7832270.

16. Tsai MC, Hemenway D. Effect of the mandatory helmet law in Taiwan. Injury Prevention: Journal of the Internation Society for Child and Adolescent Injury Prevention. 1999;5(4):290–1. doi: 10.1136/ip.5.4.290 10628919.

17. Ferrando J, Plasencia A, Oros M, Borrell C, Kraus JF. Impact of a helmet law on two wheel motor vehicle crash mortality in a southern European urban area. Injury Prevention: Journal of the Internation Society for Child and Adolescent Injury Prevention. 2000;6(3):184–8. doi: 10.1136/ip.6.3.184 11003182.

18. Servadei F, Begliomini C, Gardini E, Giustini M, Taggi F, Kraus J. Effect of Italy’s motorcycle helmet law on traumatic brain injuries. Inj Prev. 2003;9(3):257–60. doi: 10.1136/ip.9.3.257 12966016.

19. Branas CC, Knudson MM. Helmet laws and motorcycle rider death rates. Accident; analysis Prevention. 2001;33(5):641–8. doi: 10.1016/s0001-4575(00)00078-6 11491244.

20. Yu WY, Chen CY, Chiu WT, Lin MR. Effectiveness of different types of motorcycle helmets and effects of their improper use on head injuries. Internation journal of Epidemiology. 2011;40(3):794–803. doi: 10.1093/ije/dyr040 21389036.

21. OECD/ITF. Road Safety Annual Report 2015. [cited 1 November 2016].

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2020 Číslo 1
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