Impact of wearing a helmet on the risk of hospitalization and intracranial haemorrhage after a sports injury

ABSTRACT

Background: Despite their reported protective effect against the occurrence of head injuries, helmets are still used inconsistently in sports in which they are optional. We aimed to assess the impact of helmet use on the risk of hospitalization and intracranial haemorrhage for trauma occurring during sport activities.

Methods: Retrospective cohort of all patients who presented themselves, over an 18-month period, at the emergency department of a tertiary trauma centre for an injury sustained in a sport or leisure activity where the use of a helmet is optional. Impact of helmet use was assessed using multivariable regression analyses (relative risks, RR).

Results: Among the 1,022 patients included in the study, half were cyclists and 40% were skiers or snowboarders. A total of 40 % of patients wore a helmet at the time of injury, 18% had a head injury, 16% were hospitalized and 13% of patients with a head injury had an intracranial haemorrhage. Among all patients, no association was observed between hospital admission and helmet use. However, helmet use in patients with a head injury was associated with significant reductions in the risks of hospitalization (RR 0.41 [95% CI: 0.22–0.76]) and intracranial haemorrhage (RR 0.28 [95% CI: 0.11–0.71]).

Conclusions: Results suggest that, in recreational athletes who sustain a head injury, helmet use is associated with a reduced risk of hospitalization (all sports) and intracranial haemorrhage (cyclists).

KEYWORDS:

• Concussion
• head injury
• helmet
• hospitalization
• sport
• trauma

Acknowledgments

The authors thank Virginie Bergeron-Larose, Antoine Carpentier and Simon Poirier for their help during data collection.

Declaration of interest

The authors report no declarations of interest.

Additional information

Funding

This work was supported by CHIRPP (to NLS); and Association des Médecins d’Urgence du Québec (AMUQ) and the Départment de médecine familiale et de médecine d’urgence, Faculté de Médecine, Université Laval (DMFMU) (to MLP).