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Hsin-Yi Lee, PhD, Yeh-Hsin Chen, MS, Wen-Ta Chiu, MD, PhD, Jing-Shiang Hwang, PhD and Jung-Der Wang, MD, ScD

Hsin-Yi Lee, Yeh-Hsin Chen, and Jung-Der Wang are with Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taiwan, Republic of China. Wen-Ta Chiu is with the Institute of Injury Prevention and Control, Taipei Medical University, Taiwan. Jing-Shiang Hwang is with the Institute of Statistical Science, Academia Sinica, Taiwan. Jung-Der Wang is also with the Department of Internal Medicine and the Department of Environmental and Occupational Medicine, National Taiwan University Hospital.

Correspondence: Correspondence should be sent to Jung-Der Wang, MD, ScD, Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Room 719, No. 17, Xu-Zhou Road, Taipei 10055, Taiwan (e-mail: jdwang{at}ntu.edu.tw). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We estimated loss of quality-adjusted life expectancy (QALE) 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 QALE 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 QALE 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.

This article has been cited by other articles:

				H.-Y. Lee, J.-S. Hwang, J.-S. Jeng, and J.-D. Wang Quality-Adjusted Life Expectancy (QALE) and Loss of QALE for Patients With Ischemic Stroke and Intracerebral Hemorrhage: A 13-Year Follow-Up Stroke, April 1, 2010; 41(4): 739 - 744. [Abstract] [Full Text] [PDF]