INTRACRANIAL INJURY AND MORTALITY ASSOCIATED WITH MOTORCYCLE-RELATED HOSPITALIZATIONS: DIFFERENCES IN INCIDENCE AND COSTS ON THE BASIS OF UNIVERSAL MOTORCYCLE HELMET USE LEGISLATION IN THE UNITED STATES Público

Parker, Brenda Marie (2011)

Permanent URL: https://etd.library.emory.edu/concern/etds/bz60cw889?locale=pt-BR
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Abstract

Intracranial Injury and Mortality Associated with Motorcycle-related Hospitalizations: Differences in Incidence and Costs on the Basis of Universal
Motorcycle Helmet Use Legislation in the United States

Objectives: To compare the incidence of intracranial injury and in-hospital mortality as well as costs associated with motorcycle-related hospitalizations on the basis of universal motorcycle helmet legislation in the United States.

Methods: A retrospective cross-sectional ecological database analysis was performed using all hospitalizations with a supplementary classification of external causes of injury and poisoning code for motorcycle-related crashes from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample for the years 2005 to 2007. Differences in intracranial injury and mortality rates as well as costs were compared between two groups defined by the presence or absence of universal motorcycle helmet use legislation in the US.

Results: Over the analysis period, there were 87,616 injury-related hospital discharges as a result of motorcycle-related crashes. In the absence of universal motorcycle helmet use legislation, intracranial injury and in-hospital mortality was 20% and nearly four times more likely to occur, respectively, than in its presence (OR 1.20; 95% CI 1.022-1.418 and OR 3.825; 95% CI 3.061-4.781, respectively). Mean costs associated with hospitalization were higher in the presence of universal legislation than where it was absent, $60,478 and $23,243, respectively (p<0.0018).

Conclusions: Additional research and advocacy of other public health models and injury prevention strategies to complement motorcycle helmet use legislation is warranted to increase the likelihood that Congress may uphold any future legislation that encourages state adoption of universal motorcycle helmet use legislation as persuasion of state legislatures to maintain or re-enact such legislation based on fact alone has, to-date, proven futile.

Table of Contents

Distribution Agreement Abstract Acknowledgements Introduction Problem Statement Purpose Statement Research Questions and Hypotheses Significance Statement Definition of Terms Review of the Literature Methods Overview Patient Selection Data Source Study Measures Data Analysis Results Conclusions and Discussion Tables Table 1. Medical Subject Headings (MeSH) Classification and Terms Table 2. Study Population Demographics Table 3. Study Population Clinical Characteristics Table 4. Demographics According to Motorcycle Helmet Use Legislation Table 5. Clinical Characteristics According to Motorcycle Helmet Use Legislation Table 6. Tests of Association for Intracranial Injury, In-hospital Mortality and Costs Table 7. Final Regression Model Parameters for Intracranial Injury Table 8. Final Regression Model Parameters for In-hospital Mortality Table 9. Final Regression Model Parameters for Costs Appendices Appendix 1. External Causes of Injury and Poisoning Codes (ECodes) For Motorcycle-Related Crashes References

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