影响自行车相关损伤严重程度的因素：头盔在预防头部损伤中的作用。

Factors affecting severity of bicycle-related injuries: the role of helmets in preventing head injuries.

作者信息

Abu-Zidan Fikri M, Nagelkerke Nico, Rao Sudhakar

机构信息

Trauma Services, Royal Perth Hospital, Perth, Western Australia, Australia.

出版信息

Emerg Med Australas. 2007 Aug;19(4):366-71. doi: 10.1111/j.1742-6723.2007.00967.x.

DOI:10.1111/j.1742-6723.2007.00967.x

PMID:17655641

Abstract

OBJECTIVES

To identify factors that affect the severity of bicycle-related injuries in patients with head injury compared with those without, so as to find whether the effect of using helmets extends beyond head protection, and to explore a direct protective effect of helmets on head injuries.

METHODS

A total of 297 patients with bicycle-related injuries were studied. A generalized linear model was used to test the effect of age, sex, helmet use, cause of injury, year of injury, place of injury and whether the injury occurred on public or school holidays on the Injury Severity Score (ISS) in those patients who had head injury and those without. A logistic regression model was used to define the factors that contribute to head injury, while adjusting for ISS.

RESULTS

Factors affecting ISS in the generalized linear model in those who had head injury were: cause of injury (P = 0.01) and there was a trend for helmet use (P = 0.06). The significant factors that have affected ISS in the no head injury group were age (P = 0.002) and place of accident (P = 0.03). Logistic regression has shown that with each increase of 1 point in the ISS the odds of head injury increases by a factor of 1.22 (95% confidence interval 1.13-1.31) and the use of helmets reduces the odds of head injury by a factor of 0.48 (95% confidence interval 0.23-1.03).

CONCLUSIONS

The reduced severity of injury in helmeted patients is because of protection of the head and not other body regions.

摘要

目的

确定与未发生头部损伤的患者相比，影响头部损伤患者自行车相关损伤严重程度的因素，以查明使用头盔的作用是否超出头部保护范围，并探究头盔对头部损伤的直接保护作用。

方法

共研究了297例自行车相关损伤患者。采用广义线性模型，测试年龄、性别、头盔使用情况、损伤原因、损伤年份、损伤地点以及损伤是否发生在公共假日或学校假期对有头部损伤和无头部损伤患者的损伤严重程度评分（ISS）的影响。使用逻辑回归模型确定导致头部损伤的因素，同时对ISS进行校正。

结果

广义线性模型中，影响有头部损伤患者ISS的因素为：损伤原因（P = 0.01），头盔使用情况有一定趋势（P = 0.06）。影响无头部损伤组ISS的显著因素为年龄（P = 0.002）和事故发生地点（P = 0.03）。逻辑回归显示，ISS每增加1分，头部损伤的几率增加1.22倍（95%置信区间1.13 - 1.31），使用头盔使头部损伤的几率降低0.48倍（95%置信区间0.23 - 1.03）。