Investigation of the potential to enhance emergency response to motorcyclists involved in crashes The George Institute for Global Health and Monash University Soufiane Boufous, Belinda Gabbe, Jane Elkington, Megan Bohensky, Peter Cameron, Liz de Rome June 2012 Sponsoring Organisation This report was prepared for VicRoads This project was funded by the Motorcycle Safety Levy. Disclaimer This report is disseminated in the interests of information exchange to improved motorcycle safety. The views expressed here are those of the author(s) and do not necessarily reflect the views of VicRoads. The content of this report may not be reproduced without the written permission of the Director - Road User Safety, VicRoads. 1 TABLE OF CONTENTS EXECUTIVE SUMMARY................................................................................................... 6 1. BACKGROUND............................................................................................................. 13 2. DATA AND METHODS................................................................................................ 15 2.1 Interrogation of relevant databases................................................................................. 15 2.1.1 Sources of data............................................................................................................. 15 2.1.2 Data analysis................................................................................................................ 21 2.2 Literature review............................................................................................................. 24 2.3 Survey of motorcycle riders............................................................................................ 25 2.4 Consultation with stakeholders....................................................................................... 26 3. RESULTS........................................................................................................................ 27 3.1 Population-based databases............................................................................................. 27 I. Police reported motorcycle crashes……………………………………………………... 27 II. Victorian Emergency Minimum Dataset (VEMD)........................................................... 37 III. Victorian Admitted Episode Dataset (VAED)................................................................. 44 IV. National Coroners Information System (NCIS).............................................................. 51 V. Victorian State Trauma Registry (VSTR)........................................................................ 55 VI. Victorian Orthopaedic Trauma Outcomes Registry (VOTOR)...................................... 85 3.2 Literature review on strategies to improve emergency response to motorcycle crashes................................................................................................................................... 96 3.3 Survey of motorcycle riders in Victoria......................................................................... 109 3.4 Consultations with emergency services and motorcycle community representatives....................................................................................................................... 116 4. SUMMARY AND DISCUSSION................................................................................. 129 5. CONCLUSIONS............................................................................................................ 137 6. REFERENCES............................................................................................................... 139 Appendix I: List of relevant data sources identified............................................................. 143 Appendix II: Summary of included original studies and literature reviews...................... 144 2 LIST OF TABLES Table 1: Motorcycle crashes - location and road characteristics.......................................... 30 Table 2: Top 20 LGAs where motorcycle crashes occurred in Victoria, 2001-2010........... 31 Table 3: Common types of motorcycle crashes according to road user movements Victoria 2001 2010............................................................................................................... 32 Table 4: The number of motorcycle crash casualties, by severity of injury and road user type Victoria 2001-2010................................................................................................ 33 Table 5: Helmet wearing status among motorcycle crash casualties by age, Victoria 2001-2010................................................................................................................ 35 Table 6: Helmet wearing status among motorcycle crash casualties by road user type, Victoria 2001-2010....................................................................................................... 35 Table 7: Licence status of motorcycle riders involved in crashes in Victoria, 2001-2010.............................................................................................................................. 36 Table 8: Age and sex standardised rates of non-admitted motorcycle-involved ED presentations (per 100,000 population).................................................................................. 38 Table 9: Demographic characteristics of motorcycle-involved ED presentations (n=20,357)....................................................................................................... 39 Table 10: Prevalence of injuries to AIS body regions for motorcycle-related ED presentations................................................................................................................... 42 Table 11: Demographic characteristics of motorcycle-involved hospital admissions (n=9,012)............................................................................................................ 45 Table 12: Age and sex standardised rates motorcycle-involved hospital admissions (per 100,000 population)....................................................................................................... 46 Table 13: Injury event details of VAED motorcycle-related trauma (n=9,012)................... 46 Table 14: Prevalence of injury to AIS body region for motorcycle related hospital admissions............................................................................................................................ 47 Table 15: Admission and discharge characteristics of motorcycle-involved hospital admissions (n=9,012)............................................................................................................ 49 Table 16: Demographic characteristics of motorcycle-related deaths reported to a Coroner (n=239)............................................................................................................. 52 Table 17: Characteristics of motorcycle crashes reported to a Coroner................................ 52 Table 18: Location of injuries for motorcycle-involved deaths reported to a Coroner (n=213).................................................................................................................... 53 Table 19: Cause of death for motorcycle-involved cases reported to a Coroner (n=235).... 54 Table 20: Incidence of motorcycle-related major trauma cases occurring in Victoria (n=1,166)............................................................................................................................... 55 Table 21: Demographic and pre-injury status of motorcycle-related major trauma (n=1,166)............................................................................................................................... 56 Table 22: Location of motorcycle-related major trauma crashes.......................................... 58 Table 23: Most common statistical locations of motorcycle related major trauma.............. 59 Table 24: Prevalence of injury to each AIS body region for motorcycle related major trauma......................................................................................................................... 61 Table 25: Predictors of time from ‘000’ call to arrival of ambulance at the scene (multivariate linear regression)............................................................................................. 64 Table 26: Predictors of time at the scene (multivariate linear regression)........................... 69 Table 27: Predictors of transport time from the scene to hospital (multivariate linear regression)............................................................................................................................ 71 Table 28: Predictors of the time from injury to arrival at definitive care (log(hours)) (multivariate linear regression)............................................................................................. 74 Table 29: In-hospital management and outcomes of motorcycle-related major 3 trauma cases.......................................................................................................................... 75 Table 30: Association between patient factors, injury event, injuries sustained and in-hospital mortality...................................................................................................... 76 Table 31: Predictors of in-hospital mortality (multivariate analysis).................................. 77 Table 32: Functional outcome (GOS-E) at 6 and 12-months post-injury........................... 78 Table 33: Predictors