Analysis of different safety devices in the prevention of motorcycle-related craniofacial trauma - A retrospective study

Abstract

Introduction: Motorcycle accidents are one of the most frequent causes of trauma. Safety devices and helmets can influence the severity of injuries. Our retrospective study wants to evaluate the different effectiveness of Open-face and Full-face helmets in the prevention of craniofacial trauma. Materials and Methods: The sample consists of 440 patients admitted to two Level I Trauma Centres in Northern Italy, between January 2002 and February 2019, because of motorcycle-related craniofacial trauma. For each patient personal data were collected, as well as type and site of fractures, type of helmet, if worn, Comprehensive Facial Injury (CFI) score and Abbreviated Injury Score (AIS-Head) for head injuries. Inferential statistical analysis was then conducted. Results: Two hundred and eighty-eight patients wore Open-face helmets (69.7%) and 125 patients wore Full-face ones (30.3%). Mean CFI score (Standard deviation - SD) observed in patients with Open-face helmets was 7.0 (SD: 6.8) and surgery was required in 149 cases (51.7%); while it was 4.9 (SD: 6.0) in patients with Full-face helmets for whom surgery was required in 43 cases (34.4%) ( P < 0.0001 and P = 0.002, respectively). Multivariate analysis shows that severity of facial trauma is a significant risk factor for head injury severity with OR 1.90 (95% confidence interval: 1.43 - 2.51) and P < 0.0001. Discussion: Full-face helmets are definitely considered to be more protective for facial trauma, which is also a significant risk factor for the severity of head injuries. The type of helmet chosen influences the need of surgical treatment in case of craniofacial trauma.

The Comprehensive Facial Injury (CFI) Score Is an Early Predictor of the Management for Mild, Moderate and Severe Facial Trauma

“…In 2019, the Comprehensive Facial Injury (CFI) score was introduced and validated as a widely descriptive and simple scale, able to graduate the clinical severity of all kinds of facial injuries [ 1 ]. It showed a high statistical significance correlated to the outcomes of traditional trauma (overall surgical time and length of hospitalization) and the incidence of associated injuries [ 2 , 3 , 4 ] and was subsequently used for many scientific researches [ 3 , 4 , 16 , 17 , 18 ]. The CFI score is distributed on a discrete interval scale, but it has not yet been evaluated for its usefulness in stratifying groups of patients with similar behavior.…”

“…It has excellent informative content because it is firmly related to traditional trauma outcomes, such as Overall Surgical Time (OST) and Length of Stay (LOS), which are expressions of Trauma Center’s resource involvement in acute care [ 2 ]. A high CFI score also seems to be linked with a high incidence of associated injuries, such as head and other extra-cerebral injuries, and an increased risk of Intensive Care Unit (ICU) admission [ 2 , 3 , 4 ].…”