N. Lu1,2, C. C. Butler1,2,3, A. Gogineni1, J. M. Sarmiento1, E. B. Lineen1,2, G. D. Pust1,2, D. D. Yeh1,2, M. Babu4, N. Namias1,2, P. M. Byers1,2 1University Of Miami,Miami, FL, USA 2Jackson Memorial Hospital,Miami, FL, USA 3John H. Stroger, Jr. Hospital of Cook County,Chicago, IL, USA 4Massachusetts General Hospital,Boston, MA, USA
Introduction: The National Academies of Science, Engineering and Medicine (NASEM) laid out a roadmap to achieve zero preventable trauma deaths. In the U.S., there are over 5,000 motorcycle fatalities annually. According to the National Highway Traffic Safety Administration, Florida leads the nation in annual motorcycle crash (MCC) deaths and injuries. It is unknown how many are potentially preventable. To fill this gap, we aim to: 1) test the hypothesis that there are patterns of injuries in scene fatalities that are survivable, and 2) propose ideas to achieve the NASEM objective.
Methods: Miami-Dade County medical examiner reports of MCC deaths from 2010-2012 were reviewed by two board-certified surgeons. Emergency Medical Service/law enforcement reports for each subject were reviewed. Causes of death were categorized into exsanguination, traumatic brain injury (TBI)/decapitation, or airway-related. Data for MCC deaths pronounced dead on scene were analyzed. Determination of survivable vs. non-survivable injuries was based upon whether the riders had survivable injuries had they been transported immediately to a trauma center. All TBI cases were reviewed by a board-certified neurosurgeon.
Results: A total of 60 MCC scene deaths were analyzed. Ninety five percent were male, 55% were helmeted, and 38% tested positive for toxicology. Median Injury Severity Score was 41 (Range 14-75, IQR 31-75). Nineteen (32%) deaths were determined as survivable, with death due to airway in 14, and exsanguination in 4 subjects.
Conclusion: Nearly one-third of on-scene urban motorcycle deaths are potentially preventable in a relatively young patient population. ISS score comparison demonstrates the lower injury burden in the patients deemed potentially survivable. Automatic alert systems in motorcycles and first-responder training to police are recommended to improve trauma system efficacy in reducing preventable deaths from MCCs.
