Quality-Adjusted Life-Years and Helmet Use among Motorcyclists Sustaining Head Injuries

Abstract

We estimated loss of quality-adjusted life expectancy (GALE) among motorcyclists in Taiwan who sustained head injuries while wearing or not wearing a helmet. Methods. Patients with head injuries (n=3328) were grouped into categories representing good and poor outcomes (moderate disability or death) at discharge. After linkage with the National Mortality Registry, survival functions were determined and extrapolated over a 50-year period on the basis of the survival ratio between patients and age- and gender-matched reference populations, as calculated from available Taiwan vital statistics. Survival functions were then multiplied by scores from quality-of-life measures. Results. Percentages of good and poor outcomes were 87.2% and 12.8%, respectively , in the helmeted group and 66.4% and 33.6% in the nonhelmeted group. The mean GALE for helmeted motorcyclists, calculated by weighting percentages of good and poor outcomes, was 31.7 quality-adjusted life-years (QALYs), with an average loss of 5.8 QALYs. For nonhelmeted motorcyclists , the mean GALE was 25.9 QALYs, with a loss of 10.7 QALYs. Conclusions. Helmet use could save approximately 5 QALYs among motorcyclists sustaining head injuries. Future cost- effectiveness analysis can calculate the incremental cost- effectiveness ratio for regulation of helmet use.