Motorcycle helmet effectiveness in reducing head, face and brain injuries by state and helmet law.

BACKGROUND: Despite evidence that motorcycle helmets reduce morbidity and mortality, helmet laws and rates of helmet use vary by state in the U.S. METHODS: We pooled data from eleven states: five with universal laws requiring all motorcyclists to wear a helmet, and six with partial laws requiring only a subset of motorcyclists to wear a helmet. Data were combined in the Crash Outcome Data Evaluation System's General Use Model and included motorcycle crash records probabilistically linked to emergency department and inpatient discharges for years 2005-2008. Medical outcomes were compared between partial and universal helmet law settings. We estimated adjusted relative risks (RR) and 95 % confidence intervals (CIs) for head, facial, traumatic brain, and moderate to severe head/facial injuries associated with helmet use within each helmet law setting using generalized log-binomial regression. RESULTS: Reported helmet use was higher in universal law states (88 % vs. 42 %). Median charges, adjusted for inflation and differences in state-incomes, were higher in partial law states (emergency department $1987 vs. $1443; inpatient $31,506 vs. $25,949). Injuries to the head and face, including traumatic brain injuries, were more common in partial law states. Effectiveness estimates of helmet use were higher in partial law states (adjusted-RR (CI) of head injury: 2.1 (1.9-2.2) partial law single vehicle; 1.4 (1.2, 1.6) universal law single vehicle; 1.8 (1.6-2.0) partial law multi-vehicle; 1.2 (1.1-1.4) universal law multi-vehicle). CONCLUSIONS: Medical charges and rates of head, facial, and brain injuries among motorcyclists were lower in universal law states. Helmets were effective in reducing injury in both helmet law settings; lower effectiveness estimates were observed in universal law states.

Epidemiology of emergency department-treated traumatic brain injury in Minnesota.

A number of population-based studies have been published on mortality and hospitalizations associated with traumatic brain injury (TBI). However, very little has been published on treatment of TBI in the emergency department (ED), despite the fact that most cases are seen in such settings. Minnesota is 1 of 2 states funded by the Centers for Disease Control and Prevention since 2001 to conduct surveillance of TBIs treated in EDs. A sample of medical records from 2002 and 2003 was reviewed to better understand the epidemiology of ED-treated TBI and identify risk factors for and interventions to prevent them. We found males, infants, adolescents and young adults, blacks, and residents of the 7-county Twin Cities metropolitan area were most likely to be seen in the ED for TBI. Sports and recreational activities were the leading causes of these injuries, followed by falls and motor vehicle crashes.

Epidemiology of trauma in Minnesota.

Injury accounts for more than 2,500 deaths and 300,000 hospital admissions in Minnesota each year. Using the 2002 Minnesota hospital discharge database, we examined the subset of hospital-treated injuries that received trauma care and categorized claims into trauma-related deaths, cases of nonfatal major trauma, and other cases that received specialized trauma care. We also examined where trauma patients received their care, the leading diagnoses for trauma deaths and nonfatal major trauma, and whether a statewide trauma system that would identify and equip more hospitals as trauma centers would have significant potential for improving trauma care in Minnesota.