title: Repeal of the Michigan helmet law: early clinical impacts.
abstract: BACKGROUND
  Michigan repealed a 35-year mandatory helmet law on April 13, 2012. We examined the early clinical impacts at a level 1 trauma center in West Michigan.
  
  
  METHODS
  Retrospective cohort study comparing outcomes among motorcycle crash victims in a 7-month period before and after the helmet law repeal.
  
  
  RESULTS
  One hundred ninety-two patients were included. After the repeal, nonhelmeted motorcyclists rose from 7% to 29% (P < .01). There was no difference in mortality rate after admission; however, crash scene fatalities increased significantly. Intensive care unit length of stay, mechanical ventilation time, and cost of stay were also higher in the nonhelmeted cohort (P < .05).
  
  
  CONCLUSIONS
  Our study highlights the negative ramifications of repealing a mandatory helmet law. Motorcyclists not wearing helmets increased significantly in a short period of time. Nonhelmeted motorcyclists more frequently died on the scene, spent more time in the intensive care unit, required longer ventilator support, and had higher medical costs.
authors.affiliation: Department of General Surgery, Michigan State University and Grand Rapids Medical Education Partners, 221 Michigan NE Street 200A, Mail Code 106, Grand Rapids, MI 49503, USA.
authors.forename: Alistair J
authors.initials: AJ
authors.lastname: Chapman
authors.affiliation: Department of General Surgery, Michigan State University and Grand Rapids Medical Education Partners, 221 Michigan NE Street 200A, Mail Code 106, Grand Rapids, MI 49503, USA. Electronic address: rachelatitus@gmail.com.
authors.forename: Rachel
authors.initials: R
authors.lastname: Titus
authors.affiliation: Department of General Surgery, Michigan State University and Grand Rapids Medical Education Partners, 221 Michigan NE Street 200A, Mail Code 106, Grand Rapids, MI 49503, USA.
authors.forename: Hannah
authors.initials: H
authors.lastname: Ferenchick
authors.affiliation: Department of General Surgery, Michigan State University and Grand Rapids Medical Education Partners, 221 Michigan NE Street 200A, Mail Code 106, Grand Rapids, MI 49503, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Davis
authors.affiliation: Department of General Surgery, Michigan State University and Grand Rapids Medical Education Partners, 221 Michigan NE Street 200A, Mail Code 106, Grand Rapids, MI 49503, USA.
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodriguez
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D009049:Motorcycles / Q000331:legislation & jurisprudence*; D012189:Retrospective Studies; D014193:Trauma Centers / Q000191:economics / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000191:economics / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy
keywords: Helmet; Mandatory helmet law; Michigan; Mortality; Motorcycle; Repeal