Quality-adjusted life-years and helmet use among motorcyclists sustaining head injuries.
OBJECTIVE
We estimated loss of quality-adjusted life expectancy (QALE) among motorcyclists in Taiwan who sustained head injuries while wearing or not wearing a helmet.


METHODS
Patients with head injuries (n=3328) were grouped into categories representing good and poor outcomes (moderate disability or death) at discharge. After linkage with the National Mortality Registry, survival functions were determined and extrapolated over a 50-year period on the basis of the survival ratio between patients and age- and gender-matched reference populations, as calculated from available Taiwan vital statistics. Survival functions were then multiplied by scores from quality-of-life measures.


RESULTS
Percentages of good and poor outcomes were 87.2% and 12.8%, respectively, in the helmeted group and 66.4% and 33.6% in the nonhelmeted group. The mean QALE for helmeted motorcyclists, calculated by weighting percentages of good and poor outcomes, was 31.7 quality-adjusted life-years (QALYs), with an average loss of 5.8 QALYs. For nonhelmeted motorcyclists, the mean QALE was 25.9 QALYs, with a loss of 10.7 QALYs.


CONCLUSIONS
Helmet use could save approximately 5 QALYs among motorcyclists sustaining head injuries. Future cost-effectiveness analysis can calculate the incremental cost-effectiveness ratio for regulation of helmet use.
Lee
Hsin-Yi
HY
Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Room 719, No. 17, Xu-Zhou Road, Taipei 10055, Taiwan.
Chen
Yeh-Hsin
YH
Chiu
Wen-Ta
WT
Hwang
Jing-Shiang
JS
Wang
Jung-Der
JD
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D015331:Cohort Studies; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000401:mortality; D003430:Cross-Sectional Studies; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009049:Motorcycles; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012016:Reference Values; D012042:Registries; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome