The association of helmet use with the outcome of motorcycle crash injury when controlling for crash/injury severity

Accid Anal Prev. 1993 Jun;25(3):347-53. doi: 10.1016/0001-4575(93)90028-u.


Many studies have reported that helmet use by motorcycle riders significantly decreases their risk of head injury, death, and disability in the event of a crash. However, these studies have not controlled for crash severity and thus do not conclusively show the value of helmet use by motorcycle riders. Using data from a statewide trauma registry, the present study examines the association of helmet use with various outcomes of motorcycle crashes, controlling for overall crash severity as measured by a modified Injury Severity Score. The results show that in crashes where the overall degree of injury was comparable, the risk of head injury in hospitalized motorcyclists was nearly twice as high for unhelmeted riders as it was for helmeted riders, thus confirming the protective effects of helmet use. However, there were no significant differences in various measurements of resource utilization, including days in hospital, hospital charges, and need for post-hospital rehabilitation. A higher incidence of extremity injuries among the helmeted riders may account for their failure to demonstrate consistently lower resource utilization, despite lower rates of head injury.

MeSH terms

  • Accidents, Traffic* / statistics & numerical data
  • Adult
  • Bias
  • Craniocerebral Trauma / epidemiology
  • Craniocerebral Trauma / prevention & control*
  • Female
  • Head Protective Devices / statistics & numerical data*
  • Humans
  • Male
  • Motorcycles* / statistics & numerical data
  • North Carolina / epidemiology
  • Risk
  • Trauma Severity Indices