Helmeted vs nonhelmeted: a retrospective review of outcomes from 2-wheeled vehicle accidents at a level 1 trauma center.

This article reports on a retrospective review of the outcomes from 2-wheeled vehicle accidents and the impact of helmet use or non-use. The authors focus on the state of Florida, which rescinded its mandatory motorcycle helmet law in 2000. In the 10 years since this change, helmet use has dropped dramatically, and motorcycle fatalities have increased rapidly. In this study, the authors analyzed all 2-wheeled vehicle accidents evaluated at a level 1 trauma center over a 5-year period (2005-2010), comparing all outcomes, costs, and insurance status for helmeted and nonhelmeted riders (n = 1,439). Outcomes were compared for baseline population statistics, Glasgow Outcome Scale score, cost of hospitalization, discharge outcome, and health insurance status. In the 1,331 patients with full data, 995 (74.8%) were involved in motorcycle accidents, 249 (18.7%) were involved in bicycle accidents, and 87 (6.5%) were involved in scooter/moped accidents. Overall, 749 riders were nonhelmeted and 582 were helmeted. In the motorcycle group, there were 522 helmeted and 473 nonhelmeted riders. For the population of bicycle riders, there were 204 male and 45 female riders. For all vehicle types, hospital charges were skewed to the right, with a few expensive stays raising the overall average. For motorcycle riders, the average and median charges were significantly higher in nonhelmeted patients. For bicycle and scooter patients, no statistical significance was found; however, overall maximum charges were greatest in the nonhelmeted patients. In regard to insurance status, overall, riders wearing helmets were significantly more likely to have insurance than nonhelmeted riders. The authors conclude that, for the largest population (motorcycle riders), the results clearly demonstrate that helmets are effective in decreasing mortalities and improving outcomes at discharge. Also, as expected from the mortality and outcomes data, helmets significantly reduce the hospital charges for motorcycle riders involved in accidents. In estimating the cost savings for motorcycle helmet use, the authors found an average cost savings per helmeted patient of $23,603. The authors conclude that the age and insurance exemption of the law should be revoked and a universal helmet law be reinstated in the state of Florida. Motorcycle helmets significantly reduce overall morbidity and mortality, improve discharge outcome, and are cost-effective in healthcare savings.