A comparative analysis of severity of head injury sustained between rider and pillion rider in motorbike road traffic accidents

Abstract

Background
Globally, motorbike riders and pillion riders are frequently involved in road traffic accidents (RTAs), and head injuries are the major cause of morbidity and fatality.


Objective
To perform a comparative analysis of head injury severity between riders and pillion riders in motorbike RTAs and assess the factors associated with head injury severity.


Materials and methods
This hospital-based, prospective observational study involved 1000 adult motorbike riders and pillion riders who sustained head injuries following RTA. The study was performed in the Department of Neurosurgery of a tertiary care institute from February 2023 to January 2024. Modified Glasgow Coma Scale was used to determine the head injury severity. Univariate and multivariate logistic regression analysis was done to evaluate the association of head injury severity with various factors.


Results
Of 1000 patients, 38.4% were riders and 61.6% were pillion riders. Compared to pillion riders, a significantly greater proportion of riders had severe head injuries (p = 0.027); however, this was not significant on multivariate analysis (p = 0.9031). Severe head injuries were associated with not using a helmet (OR 8.51; 95% CI 5.24–14.59; p < 0.001), side saddle sitting posture (OR 1.76; 95% CI 1.21–2.56; p = 0.003), and need for neurosurgery (OR 2.49; 95% CI 1.86–3.32; p < 0.001), while mild–moderate head injuries were associated with higher survival (OR 0.17; 95% CI 0.148–0.196; p < 0.001).


Conclusion
Among motorbikers, severe head injuries are linked to lack of helmets use, sitting in side saddle posture, and need for surgical management, while mild–moderate head injuries are linked to lower mortality risk.