Association between types of helmet and outcomes in motorcyclists after traffic accidents

Background: The use of helmets has been promoted worldwide to protect motorcyclists from head-and-neck injuries and to reduce motorcycle accident-related mortality. However, the results of previous studies regarding the effectiveness of different types of helmets are controversial. This study aims to investigate the effectiveness of three types of helmets: half-helmets, open-face helmets, and full-face helmets, in protecting motorcyclists during traffic accidents. Materials and Methods: A total of 6991 motorcyclists, who were hospitalized between January 1, 2015, and December 31, 2019, were enrolled in this study. They were divided into two groups: those who did not wear helmets (n = 506) and those who wore helmets (n = 6,485). The latter group was subdivided according to the type of helmet used: half-helmet (n = 3,027), open-face helmet (n = 2,528), and full-face helmet (n = 930). The primary outcome was inhospital mortality. The length of hospital stay and associated head-and-neck injuries were secondary outcomes. Results: Half-helmets offered significantly less protection than full-face helmets, considering that patients using half-helmets had a significantly higher rate of the Abbreviated Injury Scale ≥ 2 injuries to the head region and significantly higher odds of sustaining subdural hematoma, subarachnoid hemorrhage (SAH), and intracerebral hematoma than patients using full-face helmets. However, higher odds of sustaining SAH were noted in patients using open-face helmets. There were no significant differences in the Glasgow Coma Scale score after injury or in the mortality rate in patients using either half-helmets or open-face helmets compared to those using full-face helmets. Conclusion: This study revealed that half-helmets, but not open-face helmets, offered significantly less protection from head injuries than full-face helmets. However, the mortality rate and length of hospital stay after the injury did not differ among patients using the three types of helmets.