Abstract

Background: Popularization of bicycle use in American cities has led to an increased number of related injuries. The purpose of this study was to determine the current prevalence and type of bicycle injuries in a large urban center from a large county hospital trauma registry.

Methods: A retrospective trauma registry study from a large urban county hospital was reviewed, which included bicycle injuries admitted during a 3-year period. Investigated variables included helmet use, demographics, mechanism of injury, type and severity of injuries, type of operations, and toxicology screening results. Mortality of patients was recorded.

Results: During the study period, 1454 patients were admitted following bicycle injuries. The most common mechanism of injury was collision with a motor vehicle without being thrown off (44%) followed by collision with a motor vehicle and subsequently being thrown off (26%). The overall use of helmet was 14%. In the age group 18 years, helmet use was 16%. 8% of patients tested positive for ethanol use and 4% had tested positive for amphetamine use. Overall, 292 patients had severe trauma (AIS>2). Significant head trauma (head AIS>2) was diagnosed in 142 patients (10%). The prevalence of significant head trauma was 35% in the group of patients with helmet and 34% in the group without helmets (p-value=0.84). It should also be noted that the prevalence of all significant trauma was 26% in the group of patients with helmet and 20% in the group without helmets (p-value=0.048). The overall mortality was 1%. There was no difference in mortality between helmeted and non-helmeted patients.

Discussion: The most common cause of these reported urban injuries was a low velocity collision with a motor vehicle without being thrown off. Up to 8% had ethanol or controlled substances in their blood. Helmet use in these injuries was just 14%. This data showed a paradoxical finding regarding the protective effect of helmets. Given the burden of bicycle injuries on society, more studies are needed.

Level of Evidence: Level III