Orsay E, Holden J A, Williams J, Lumpkin J R
Department of Emergency Medicine, University of Illinois at Chicago, USA.
Ann Emerg Med. 1995 Oct;26(4):455-60. doi: 10.1016/s0196-0644(95)70114-1.
To assess the current morbidity and mortality of motorcycle trauma in the state of Illinois and, specifically, to assess the incidence and cost of head injury to motorcycle crash patients according to their helmet use.
Retrospective, cross-sectional examination of the Illinois Department of Public Health Trauma Registry, for which data are available from July 1, 1991, through December 31, 1992. Data are collected from all hospitals designated as Level I or Level II trauma centers in Illinois.
All patients involved in motorcycle crashes and subsequently taken to a Level I or Level II trauma center in Illinois and entered into the trauma registry during the period studied.
Head injury, spinal injury, helmet use, demographic data, hospital charges, days in ICU, and source of payment were selected as outcome measures. During the 18-month study period, 1,231 motorcycle trauma patients were entered into the trauma registry. Eighteen percent were helmeted and 56.0% were nonhelmeted. In 26.0% the helmet status at the time of the crash was unknown. Thirty percent of the helmeted patients sustained head injury and 4% sustained spinal or vertebral injury, compared with 51% and 8%, respectively, for nonhelmeted patients. Nonhelmeted patients were significantly more likely to sustain severe (Abbreviated Injury Score [AIS], 3 or more) or critical (AIS, 5 or more) head injury. Patients with these serious head injuries incurred almost three times the hospital charges and used a disproportionately larger share of ICU days than those with mild or no head injuries. There was a trend toward greater use of public funds or self-pay status (no insurance) for payment of hospital charges in nonhelmeted patients.
Motorcycle helmet nonuse was associated with an increased incidence of serious head injury. Motorcycle trauma patients with severe or critical head injuries used a significantly greater proportion of ICU days and hospital charges than those with mild or no head injuries.
评估伊利诺伊州摩托车创伤的当前发病率和死亡率，具体而言，根据头盔使用情况评估摩托车事故患者头部受伤的发生率和费用。
对伊利诺伊州公共卫生创伤登记处进行回顾性横断面检查，该登记处可提供1991年7月1日至1992年12月31日的数据。数据收集自伊利诺伊州所有指定为一级或二级创伤中心的医院。
在研究期间，所有涉及摩托车事故并随后被送往伊利诺伊州一级或二级创伤中心并录入创伤登记处的患者。
选择头部受伤、脊柱损伤、头盔使用情况、人口统计学数据、住院费用、重症监护病房天数和支付来源作为结果指标。在18个月的研究期间，1231名摩托车创伤患者被录入创伤登记处。18%的患者佩戴头盔，56.0%的患者未佩戴头盔。26.0%的患者在事故发生时的头盔佩戴情况不明。佩戴头盔的患者中有30%头部受伤，4%脊柱或椎骨受伤，而未佩戴头盔的患者分别为51%和8%。未佩戴头盔的患者更有可能遭受严重（简明损伤定级 [AIS]，3级或更高）或危重（AIS，5级或更高）头部损伤。与轻度或无头部损伤的患者相比，这些严重头部损伤的患者产生的住院费用几乎是其三倍，且在重症监护病房的天数占比也过高。未佩戴头盔的患者在支付住院费用方面有更多使用公共资金或自费（无保险）的趋势。
不使用摩托车头盔与严重头部损伤的发生率增加有关。与轻度或无头部损伤的患者相比，患有严重或危重头部损伤的摩托车创伤患者在重症监护病房的天数和住院费用占比显著更高。
