Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand.
PLoS One. 2014 Jan 29;9(1):e87633. doi: 10.1371/journal.pone.0087633. eCollection 2014.
It is known that experience of a previous crash is related to incidence of future crashes in a cohort of New Zealand cyclists. This paper investigated if the strength of such association differed by crash involvement propensity and by the need for medical care in the previous crash.
The Taupo Bicycle Study involved 2590 adult cyclists recruited in 2006 and followed over a median period of 4.6 years through linkage to four national databases. The crash involvement propensity was estimated using propensity scores based on the participants' demographic, cycling and residential characteristics. Cox regression modelling for repeated events was performed with multivariate and propensity score adjustments. Analyses were then stratified by quintiles of the propensity score.
A total of 801 (31.0%) participants reported having experienced at least one bicycle crash in the twelve months prior to the baseline survey. They had a higher risk of experiencing crash events during follow-up (hazard ratio (HR): 1.43; 95% CI: 1.28, 1.60) but in the stratified analysis, this association was significant only in the highest two quintiles of the propensity score where the likelihood of having experienced a crash was more than 33%. The association was stronger for previous crashes that had received medical care (HR 1.63; 95% CI: 1.41, 1.88) compared to those that had not (HR 1.30; 95% CI: 1.14, 1.49).
Previous crash experience increased the risk of future crash involvement in high-risk cyclists and the association was stronger for previous crashes attended medically. What distinguishes the high risk group warrants closer investigation, and the findings indicate also that health service providers could play an important role in prevention of bicycle crash injuries.
已知在新西兰的一组自行车手群体中，以往的撞车经历与未来撞车事件的发生有关。本文调查了这种关联的强度是否因撞车参与倾向以及以往撞车事故中是否需要医疗护理而有所不同。
陶波自行车研究涉及 2590 名成年自行车手，他们于 2006 年招募并通过与四个国家数据库的链接，在中位数为 4.6 年的时间内进行随访。使用基于参与者的人口统计学、自行车和居住特征的倾向得分来估计撞车参与倾向。使用多变量和倾向得分调整进行重复事件的 Cox 回归建模。然后根据倾向得分的五分位数进行分层分析。
共有 801 名（31.0%）参与者报告在基线调查前的 12 个月内至少经历过一次自行车撞车事故。他们在随访期间发生撞车事件的风险更高（风险比（HR）：1.43；95%置信区间（CI）：1.28，1.60），但在分层分析中，这种关联仅在倾向得分最高的两个五分位数中显著，在这两个五分位数中，发生撞车的可能性超过 33%。与未接受医疗护理的以往撞车事故相比，接受医疗护理的以往撞车事故（HR 1.63；95%CI：1.41，1.88）的关联更强。
以往的撞车经历增加了高风险自行车手未来发生撞车事故的风险，且与以往接受过医疗护理的撞车事故的关联更强。需要更密切调查区分高风险群体的因素，研究结果还表明，卫生服务提供者可以在预防自行车撞车损伤方面发挥重要作用。
