Motorcycle riders and pillion passengers injury patterns and in-hospital outcomes based on the National Trauma Registry of Iran.

OBJECTIVE

Road traffic injury (RTI) is the second leading cause of death and disability, and motorcycle crashes rank as the first cause of traffic fatality in Iran. We aimed to compare various characteristics between traumatized motorcycle riders and pillion passengers registered with the National Trauma Registry of Iran (NTRI).

METHODS

This is a retrospective study of the NTRI, an ongoing multicenter trauma database built on a registry. This study included injured motorcyclists from six major trauma centers nationwide admitted between February 2017 and November 2023. Motorcyclists should have been hospitalized for RTIs and met the NTRI's inclusion criteria. We assessed patients regarding their demographics, clinical features, the pattern of injuries, and diverse in-hospital outcomes.

RESULTS

Of 54,342 registered patients in the NTRI, 7,594 motorcyclists were included. Of them, 6,636 (87.4%) were riders, and 958 (12.6%) were pillion passengers. Among all, 7165 (94.5%) were male, and 420 (5.5%) female ( < 0.001). Only 656 (9.9%) of riders and 24 (2.5%) of pillion passengers were wearing helmets ( < 0.001). Lone motorcyclist crashes led to injuries in 1,394 (21.2%) riders and 332 (35.5%) pillion passengers ( < 0.001). Glasgow Coma Scale (GCS) was 3 to 8 in 204 (3.1%) riders and 16 (1.7%) pillion passengers ( = 0.016). The most frequent pattern of poly-trauma was "head and thorax," with 43 (32.3%) riders and 5 (25.0%) pillion passengers ( = 0.362). Univariable logistic regression analysis showed that Intensive Care Unit (ICU) admission (OR = 0.78, CI 95% = 0.62 to 0.97,  = 0.028) and mechanical ventilation (OR = 0.58, CI 95% = 0.39 to 0.84,  = 0.004) were significantly lower in pillion passengers compared to motorcycle riders. After adjustment for age, gender, occupational status, and helmet use, being a rider or a pillion passenger didn't have a significant association with any of the in-hospital outcomes.

CONCLUSIONS

Motorcycle riders and pillion passengers sustain the same injuries in terms of pattern, severity, and in-hospital outcomes. Therefore, healthcare providers can approach them similarly. Since there is a high number of underage riders and helmets are not used commonly, there should be more police enforcement in this case.