From the Departments of Surgery (R.W., L.A.D., R.J.S., S.R.T., D.S., S.J., O.B., C.W., H.L.P., S.G.F.), Emergency Medicine (S.W., D.A.L.), and Pediatrics (D.A.L.), Bellevue Hospital Center, New York University School of Medicine; and Office of Research, Implementation and Safety (M.R.), NYC Department of Transportation, New York, New York.
J Trauma Acute Care Surg. 2013 Nov;75(5):877-81. doi: 10.1097/TA.0b013e3182a85f97.
While the efficacy of helmet use in the prevention of head injury is well described, helmet use as it relates to bicyclists' behaviors and hospital resource use following injury is less defined. The objective of this study was to compare the demographics, behaviors, hospital workups, and outcomes of bicyclists based on helmet use.
This study was a subset analysis of a 2.5-year prospective cohort study of vulnerable roadway users conducted at Bellevue Hospital Center, a New York City Level 1 trauma center. All bicyclists with known helmet status were included. Demographics, insurance type, traffic law compliance, alcohol use, Glasgow Coma Scale (GCS) score, initial imaging studies, Abbreviated Injury Scale (AIS) score, Injury Severity Score (ISS), admission status, length of stay, disposition, and mortality were assessed. Information was obtained primarily from patients; witnesses and first responders provided additional information.
Of 374 patients, 113 (30.2%) were wearing helmets. White bicyclists were more likely to wear helmets; black bicyclists were less likely (p = 0.037). Patients with private insurance were more likely to wear helmets, those with Medicaid or no insurance were less likely (p = 0.027). Helmeted bicyclists were more likely to ride with the flow of traffic (97.2%) and within bike lanes (83.7%) (p < 0.001 and p = 0.013, respectively). Nonhelmeted bicyclists were more likely to ride against traffic flow (p = 0.003). There were no statistically significant differences in mean GCS score, AIS score, and mean ISS for helmeted versus nonhelmeted bicyclists. Nonhelmeted patients were more likely to have head computed tomographic scans (p = 0.049) and to be admitted (p = 0.030).
Helmet use is an indicator of safe riding practices, although most injured bicyclists do not wear them. In this study, helmet use was associated with lower likelihood of head CTs and admission, leading to less hospital resource use. Injured riders failing to wear helmets should be targeted for educational programs.
Epidemiologic study, level III.
虽然头盔在预防头部受伤方面的功效已得到充分证实，但头盔在受伤后与自行车骑行者行为和医院资源使用之间的关系仍未得到明确界定。本研究的目的是比较基于头盔使用情况的自行车骑行者的人口统计学特征、行为、医院检查和结果。
本研究是对在纽约市一级创伤中心贝尔维尤医院中心进行的为期 2.5 年的易受伤道路使用者前瞻性队列研究的子集分析。所有已知头盔使用情况的自行车骑行者均被纳入研究。评估的内容包括人口统计学特征、保险类型、交通法规遵守情况、酒精使用情况、格拉斯哥昏迷量表（GCS）评分、初始影像学研究、损伤严重程度评分（AIS）、损伤严重程度评分（ISS）、入院状态、住院时间、处置情况和死亡率。信息主要从患者处获取；目击者和急救人员提供了其他信息。
在 374 名患者中，有 113 名（30.2%）佩戴了头盔。白人自行车骑行者更有可能佩戴头盔；黑人自行车骑行者则不太可能（p = 0.037）。有私人保险的患者更有可能佩戴头盔，而有医疗补助或没有保险的患者则不太可能（p = 0.027）。戴头盔的自行车骑行者更有可能按照交通规则行驶（97.2%）并在自行车道内行驶（83.7%）（p < 0.001 和 p = 0.013）。未戴头盔的自行车骑行者更有可能逆行行驶（p = 0.003）。戴头盔和未戴头盔的自行车骑行者的平均 GCS 评分、AIS 评分和平均 ISS 评分无统计学差异。未戴头盔的患者更有可能接受头部计算机断层扫描（p = 0.049）和入院治疗（p = 0.030）。
头盔的使用是安全骑行行为的指标，尽管大多数受伤的自行车骑行者并未佩戴头盔。在本研究中，头盔的使用与头部 CT 检查和入院的可能性降低有关，从而导致医院资源使用减少。应针对未戴头盔的受伤骑手开展教育计划。
流行病学研究，III 级。
