Citation

Gupta S, Klaric K, Sam N, Din V, Juschkewitz T, Iv V, Shrime MG, Park KB. Traffic Injury Prev. 2018; 19(1): 66-70.

Affiliation

Program in Global Surgery and Social Change , Harvard Medical School , 641 Huntington Avenue, Boston , MA 02115.

Copyright

(Copyright © 2018, Informa - Taylor and Francis Group)

DOI

10.1080/15389588.2017.1342821

PMID

28699848

Abstract

OBJECTIVE: Rapid urbanization and motorization without corresponding increases in helmet usage have made traumatic brain injury due to road traffic accidents a major public health crisis in Cambodia. This analysis was conducted to quantify the impact of helmets on severity of injury, neurosurgical indication, and functional outcomes at discharge for motorcycle operators who required hospitalization for a traumatic brain injury following a road traffic accident in Cambodia.

METHODS: The medical records of 491 motorcycle operators who presented to a major tertiary care center in Cambodia with traumatic brain injury were retrospectively analyzed using multivariate logistic regression.

RESULTS: The most common injuries at presentation were contusions (47.0%), epidural hematomas (30.1%), subdural hematomas (27.9%), subarachnoid hemorrhages (12.4%), skull fractures (21.4%), and facial fractures (18.5%). Moderate-to-severe loss of consciousness was present in 36.3% of patients. Not wearing a helmet was associated with an odds ratio of 2.20 (95% CI 1.15-4.22) for presenting with moderate to severe loss of consciousness compared to helmeted patients. Craniotomy or craniectomy were indicated for evacuation of hematoma in 20.0% of cases, and non-helmeted patients had 3.21-fold higher odds of requiring neurosurgical intervention (95% CI 1.25-8.27). Furthermore, lack of helmet usage was associated with 2.72-fold higher odds of discharge with functional deficits (95% CI: 1.14-6.49). In total, 30.1% of patients were discharged with severe functional deficits.

CONCLUSIONS: Helmets demonstrate a protective effect and may be an effective public health intervention to significantly reduce the burden of traumatic brain injury in Cambodia and other developing countries with increasing rates of motorization across the world.

Language: en

Keywords

Cambodia; Helmet Usage; Road Traffic Accidents; Traumatic Brain Injury