Motorcycle crashes and upper extremity trauma
Objectives: Upper extremity injuries following motorcycle crashes (MCC) incur increased healthcare costs and rehabilitation needs. We aim to characterize the epidemiology of MCC upper extremity injuries and identify factors that influence the severity of and cost of care for upper extremity injuries...
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| Format: | Article |
| Language: | English |
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EDP Sciences
2021-01-01
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| Series: | SICOT-J |
| Subjects: | |
| Online Access: | https://www.sicot-j.org/articles/sicotj/full_html/2021/01/sicotj200133/sicotj200133.html |
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| author | Cravez Erin Rankin Kelsey A. Ondeck Nathaniel Yaari Lee Leslie Michael Swigart Carrie Wiznia Daniel H. |
| author_facet | Cravez Erin Rankin Kelsey A. Ondeck Nathaniel Yaari Lee Leslie Michael Swigart Carrie Wiznia Daniel H. |
| author_sort | Cravez Erin |
| collection | DOAJ |
| description | Objectives: Upper extremity injuries following motorcycle crashes (MCC) incur increased healthcare costs and rehabilitation needs. We aim to characterize the epidemiology of MCC upper extremity injuries and identify factors that influence the severity of and cost of care for upper extremity injuries. Methods: We performed a retrospective cohort analysis of 571 patients with upper extremity injuries after MCC at a level 1 trauma center from 2002 to 2013. We collected data pertaining to demographics, helmet use, toxicology, bony injury, Injury Severity Score (ISS), Glasgow Coma Scale (GCS), hospital length of stay (LOS), and cost. Continuous variables were compared using t-test or Wilcoxon rank test, depending on data distribution, and dichotomous variables were compared using Pearson’s chi-squared or Fisher’s exact tests. Regression models were used to evaluate the effect of intoxication or helmets on injury location, severity, cost of care, and LOS. Results: The incidence of MCC upper extremity injury was 47.5%, with hand and forearm fractures the most common injuries (25.5% and 24.7% of total injuries). Intoxicated patients were more likely to have a high cost of care (p = 0.012), extended LOS (p = 0.038), plastic surgery involvement in their care (p = 0.038), but fewer upper extremity bony injuries (p = 0.019). Non-helmeted patients sustained less upper extremity bony injuries (p < 0.001) and upper extremity soft tissue injuries (p = 0.001), yet more severe injuries (ISS ≥ 30, p = 0.006 and GCS < 9, p < 0.01) than helmeted patients. Conclusion: Upper extremity injuries are common in motorcyclists. Despite vital protection for the brain and maxillofacial injury, helmeted MCC patients have an increased incidence of upper extremity injuries compared to non-helmeted patients, but overall have less severe injuries. Intoxicated patients have fewer upper extremity bony injuries, but the higher cost of care, and extended LOS. Therefore, even with the increased risk of injury helmets may expose to the upper extremity, helmets reduced overall morbidity and mortality. In addition to mandatory helmet laws, we advocate for further development of safety equipment focusing specifically on the prevention of upper extremity injuries. |
| first_indexed | 2024-12-23T04:24:43Z |
| format | Article |
| id | doaj.art-74c2adb075da4468be2c333a2f047886 |
| institution | Directory Open Access Journal |
| issn | 2426-8887 |
| language | English |
| last_indexed | 2024-12-23T04:24:43Z |
| publishDate | 2021-01-01 |
| publisher | EDP Sciences |
| record_format | Article |
| series | SICOT-J |
| spelling | doaj.art-74c2adb075da4468be2c333a2f0478862022-12-21T18:00:09ZengEDP SciencesSICOT-J2426-88872021-01-017810.1051/sicotj/2021007sicotj200133Motorcycle crashes and upper extremity traumaCravez Erin0Rankin Kelsey A.1https://orcid.org/0000-0001-9251-0857Ondeck Nathaniel2Yaari LeeLeslie Michael3Swigart Carrie4Wiznia Daniel H.5Yale School of MedicineYale School of MedicineHospital for Special SurgeryYale School of MedicineYale School of MedicineYale School of MedicineObjectives: Upper extremity injuries following motorcycle crashes (MCC) incur increased healthcare costs and rehabilitation needs. We aim to characterize the epidemiology of MCC upper extremity injuries and identify factors that influence the severity of and cost of care for upper extremity injuries. Methods: We performed a retrospective cohort analysis of 571 patients with upper extremity injuries after MCC at a level 1 trauma center from 2002 to 2013. We collected data pertaining to demographics, helmet use, toxicology, bony injury, Injury Severity Score (ISS), Glasgow Coma Scale (GCS), hospital length of stay (LOS), and cost. Continuous variables were compared using t-test or Wilcoxon rank test, depending on data distribution, and dichotomous variables were compared using Pearson’s chi-squared or Fisher’s exact tests. Regression models were used to evaluate the effect of intoxication or helmets on injury location, severity, cost of care, and LOS. Results: The incidence of MCC upper extremity injury was 47.5%, with hand and forearm fractures the most common injuries (25.5% and 24.7% of total injuries). Intoxicated patients were more likely to have a high cost of care (p = 0.012), extended LOS (p = 0.038), plastic surgery involvement in their care (p = 0.038), but fewer upper extremity bony injuries (p = 0.019). Non-helmeted patients sustained less upper extremity bony injuries (p < 0.001) and upper extremity soft tissue injuries (p = 0.001), yet more severe injuries (ISS ≥ 30, p = 0.006 and GCS < 9, p < 0.01) than helmeted patients. Conclusion: Upper extremity injuries are common in motorcyclists. Despite vital protection for the brain and maxillofacial injury, helmeted MCC patients have an increased incidence of upper extremity injuries compared to non-helmeted patients, but overall have less severe injuries. Intoxicated patients have fewer upper extremity bony injuries, but the higher cost of care, and extended LOS. Therefore, even with the increased risk of injury helmets may expose to the upper extremity, helmets reduced overall morbidity and mortality. In addition to mandatory helmet laws, we advocate for further development of safety equipment focusing specifically on the prevention of upper extremity injuries.https://www.sicot-j.org/articles/sicotj/full_html/2021/01/sicotj200133/sicotj200133.htmlmotorcycletraumahelmetupper extremityintoxication |
| spellingShingle | Cravez Erin Rankin Kelsey A. Ondeck Nathaniel Yaari Lee Leslie Michael Swigart Carrie Wiznia Daniel H. Motorcycle crashes and upper extremity trauma SICOT-J motorcycle trauma helmet upper extremity intoxication |
| title | Motorcycle crashes and upper extremity trauma |
| title_full | Motorcycle crashes and upper extremity trauma |
| title_fullStr | Motorcycle crashes and upper extremity trauma |
| title_full_unstemmed | Motorcycle crashes and upper extremity trauma |
| title_short | Motorcycle crashes and upper extremity trauma |
| title_sort | motorcycle crashes and upper extremity trauma |
| topic | motorcycle trauma helmet upper extremity intoxication |
| url | https://www.sicot-j.org/articles/sicotj/full_html/2021/01/sicotj200133/sicotj200133.html |
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