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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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Autores principales: Cravez, Erin, Rankin, Kelsey A., Ondeck, Nathaniel, Yaari, Lee, Leslie, Michael, Swigart, Carrie, Wiznia, Daniel H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: EDP Sciences 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7938721/
https://www.ncbi.nlm.nih.gov/pubmed/33683193
http://dx.doi.org/10.1051/sicotj/2021007
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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 PubMed
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.
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spelling pubmed-79387212021-03-09 Motorcycle crashes and upper extremity trauma Cravez, Erin Rankin, Kelsey A. Ondeck, Nathaniel Yaari, Lee Leslie, Michael Swigart, Carrie Wiznia, Daniel H. SICOT J Research Article 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. EDP Sciences 2021-03-08 /pmc/articles/PMC7938721/ /pubmed/33683193 http://dx.doi.org/10.1051/sicotj/2021007 Text en © The Authors, published by EDP Sciences, 2021 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Cravez, Erin
Rankin, Kelsey A.
Ondeck, Nathaniel
Yaari, Lee
Leslie, Michael
Swigart, Carrie
Wiznia, Daniel H.
Motorcycle crashes and upper extremity trauma
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 Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7938721/
https://www.ncbi.nlm.nih.gov/pubmed/33683193
http://dx.doi.org/10.1051/sicotj/2021007
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