title: Helmets prevent motorcycle injuries with significant economic benefits.
abstract: OBJECTIVE
  The number of registered motorcycles in the United States has been steadily increasing, as have the number of motorcycle injuries and fatalities. The Midwest has the lowest incidence of helmet use in the country. Iowa in particular has no helmet law.
  
  
  METHODS
  We conducted a retrospective study of the motorcycle crash victims treated at our level 1 trauma center between 2002 and 2008. Data from 713 motorcycle trauma victims were analyzed for correlations between helmet use and multiple outcome measures.
  
  
  RESULTS
  The helmeted cases were similar to the unhelmeted cases in demographic and most crash characteristics. Unhelmeted patients suffered more severe injuries as measured by the Injury Severity Score (P < .01) and Glasgow Coma Score (P < .01) and they had lower survival probability (P = .01). The unhelmeted patients were more likely to be smokers (P < .01), to drink alcohol (P < .01), to use drugs (P < .01), and to be involved in crashes at night (P = .03). Helmeted cases suffered fewer injuries (P < .01). Helmets reduced the risk of injury to the head by at least two thirds (P < .01) and to the cervical spine by at least half (P = .03). Helmeted patients were less likely to require mechanical ventilation or intensive care or to have infections. They were discharged an average of 3 days earlier (P < .01) and were less likely to be discharged to a care facility for additional institutional care (P = .02). Total hospital cost savings exceeded $20,000 (P = .02) per helmeted patient.
  
  
  CONCLUSIONS
  Helmets protect patients from head and neck injuries, which results in less severe injuries and a more benign hospital course. Helmet use results in significant inpatient cost savings plus additional care and social cost savings by reducing the need for further institutional care. We recommend legal and social measures to induce and encourage helmet use.
authors.affiliation: Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Philip
authors.forename: William
authors.initials: W
authors.lastname: Fangman
authors.forename: Junlin
authors.initials: J
authors.lastname: Liao
authors.forename: Michele
authors.initials: M
authors.lastname: Lilienthal
authors.forename: Kent
authors.initials: K
authors.lastname: Choi
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D017046:Cost Savings; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009049:Motorcycles; D012189:Retrospective Studies; D014481:United States; D014947:Wounds and Injuries / Q000191:economics / Q000517:prevention & control*