[Injury and death in motorcyclists: Umbrella review]

The growing use of motorcycles has improved urban mobility, but has also increased morbidity, mortality, and accident-related costs, especially in low- and middle-income countries. The main consequences include traumatic brain injury, disability, hospital expenditures, and loss of productivity among young adults. The objective was to assess the impact of motorcycle crashes on injuries, healthcare costs, and economic losses through an umbrella review (2000-2025) and to identify the most effective preventive interventions. The review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD420231103242). Two reviewers independently assessed systematic, scoping, or comprehensive narrative reviews addressing injuries, risk factors, interventions, or economic impacts; a third reviewer resolved disagreements. Primary studies were excluded. Searches were conducted in PubMed, Scopus, ScienceDirect, Epistemonikos, Google Scholar, and BVS/LILACS. Methodological quality was appraised with AMSTAR 2 and outcomes were graded using GRADE; when possible, a random-effects meta-analysis was performed in RevMan 5.4. Of 6630 records, 36 met the inclusion criteria. Full-face helmet use significantly reduced injury and mortality (OR 0.40-0.65) and decreased hospital costs (> 12,000 USD per case). Universal helmet laws and educational campaigns were effective (OR 0.53-0.82), whereas alcohol and cannabis use increased the risk of death (OR > 1.6). In conclusion, helmets are the most effective and cost-efficient preventive measure, and strict public policies on legislation and road safety education are required.