Motorised two-wheeler crash and helmets: injury patterns, severity, mortality and the consequence of gender bias

Abstract

Background: India records the maximum number of deaths from motorised two-wheeler vehicle (MTV) accidents in the world with mandatory helmet laws for males but not females. This study was designed to investigate injury patterns, severity, mortality, and helmet usage among hospital admitted victims of a MTV crash with a paired subgroup analyses on female victims.

Methods: Hospital trauma registry from January 2011 to July 2012 for all adult victims of a MTV crash was analysed for outcomes of mortality, serious head injury, severe facial injury, and cervical spine injury while adjusting for age, gender, use of alcohol/drugs, injury severity score, and presence of shock by multivariable logistic regression model. Groups of helmeted victims (HV) and nonhelmeted victims (NHV) were identified.

Results: A total of 2,718 victims were included. HV suffered maximum injuries to the lower extremity (29.04 %) and had reduced adjusted odds of death (odds ratio (OR) 0.65; 95 % confidence interval (CI) 0.48-0.86), serious head injury (OR 0.34; CI 0.26-0.45), cervical spine injury (OR 0.74; CI 0.54-1.06), and serious facial injury (OR 0.87; CI 0.57-1.26) compared with NHV who suffered maximum injuries to the head (24.49 %). Compliance with helmet use was 52.91 and 7.94 % among males and females respectively. A total of 224 pairs of male driver and female pillion involved in same MTV crash were identified, and the predominantly helmeted male had reduced odds of death (OR 0.44; CI 0.21-0.84) and severe head injury (OR 0.42; CI 0.24-0.72) compared with overwhelmingly nonhelmeted females.

Conclusions: Helmet laws must be strictly enforced, and society should think about the cost being born by its fairer counterpart by the gender-based differential law.