Rivara Frederick P, Thompson Diane C, Thompson Robert S
Harborview Injury Prevention and Research Center, Department of Pediatrics and Epidemiology, University of Washington, Seattle.
Harborview Injury Prevention and Research Center, Seattle.
Inj Prev. 2015 Feb;21(1):47-51. doi: 10.1136/injprev-00002-0038rep.
To determine the risk factors for serious injury to bicyclists, aside from helmet use.
Prospective case-control study.
Seven Seattle area hospital emergency departments and two county medical examiner's offices.
Individuals treated in the emergency department or dying from bicycle related injuries.
Information collected from injured bicyclists or their parents by questionnaire on circumstances of the crash; abstract of medical records for injury data. Serious injury defined as an injury severity score>8.
Odd ratios computed using the maximum likelihood method, and adjusted using unconditional logistic regression.
There were 3854 injured cyclists in the three year period; 3390 (88%) completed questionnaires were returned. 51% wore helmets at the time of crash. Only 22.3% of patients had head injuries and 34% had facial injuries. Risk of serious injury was increased by collision with a motor vehicle (odds ratio (OR)=4.6), self reported speed >15 mph (OR=1.2), young age (<6 years), and age >39 years (OR=2.1 and 2.2 respectively, compared with adults 20-39 years). Risk for serious injury was not affected by helmet use (OR=0.9). Risk of neck injury was increased in those struck by motor vehicles (OR=4.0), hospitalized for any injury (OR=2.0), and those who died (OR=15.1), but neck injury was not affected by helmet use.
Prevention of serious bicycle injuries cannot be accomplished through helmet use alone, and may require separation of cyclists from motor vehicles, and delaying cycling until children are developmentally ready.
确定除使用头盔外，骑自行车者受重伤的风险因素。
前瞻性病例对照研究。
西雅图地区的七家医院急诊科和两个县验尸官办公室。
在急诊科接受治疗或因自行车相关伤害死亡的个体。
通过问卷调查从受伤的骑自行车者或其父母处收集有关撞车情况的信息；从医疗记录摘要中获取伤害数据。重伤定义为损伤严重程度评分>8。
使用最大似然法计算比值比，并使用无条件逻辑回归进行调整。
在三年期间有3854名骑自行车受伤者；共返回3390份（88%）完成的问卷。51%的人在撞车时佩戴了头盔。只有22.3%的患者有头部受伤，34%有面部受伤。与机动车相撞（比值比（OR）=4.6）、自我报告速度>15英里/小时（OR=1.2）、年龄<6岁以及年龄>39岁（与20 - 39岁的成年人相比，OR分别为2.1和2.2）会增加重伤风险。使用头盔对重伤风险没有影响（OR=0.9）。被机动车撞击的人（OR=4.0）、因任何伤害住院的人（OR=2.0）以及死亡的人（OR=15.1）颈部受伤风险增加，但使用头盔对颈部受伤没有影响。
预防严重的自行车伤害不能仅通过使用头盔来实现，可能需要将骑自行车者与机动车分隔开，并在儿童发育成熟后再开始骑行。
