Hagel Brent E, Romanow Nicole T R, Enns Nancy, Williamson Jacqueline, Rowe Brian H
Departments of Paediatrics & Community Health Sciences, Alberta Children's Hospital Research Institute for Child & Maternal Health, Cumming School of Medicine, University of Calgary, C4-434, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, Alberta T3B 6A8, Canada.
Faculty of Kinesiology and Department of Paediatrics, Cumming School of Medicine, University of Calgary, KNB3300, 2500 University Dr. NW Calgary, Alberta T2N 1N4, Canada.
Accid Anal Prev. 2015 May;78:165-172. doi: 10.1016/j.aap.2015.03.002. Epub 2015 Mar 16.
Bicycling is the most common cause of sports and recreation injury in children and adolescents; yet, there is limited evidence on the factors associated with severe bicycling injuries in youth.
Case-control study of injured bicyclists less than 18 years old seen in seven emergency departments (EDs) from May 2008 to October 2010. Cases were bicyclists hospitalized after their ED visit (severe injury). Controls were bicyclists seen and discharged from the ED (non-severe injury). Personal, environmental, and crash characteristics were collected by interview. Injury data were collected from medical charts. Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) from logistic regression were used to estimate the odds of hospitalization associated with risk factors. Multiple imputation techniques were employed to address missing data.
There were 1470 participants including 119 cases. Those ages 13-17 had the highest proportion (23%) of severe injuries resulting from motor vehicle [MV] collision. In models including age, sex and MV collision, being male (OR: 2.02; 95% CI: 1.21-3.38), not wearing a helmet (OR: 2.18; 95% CI: 1.43-3.31) and MV collision (OR: 3.91; 95% CI: 2.26-6.78) were significant risk factors for severe injury. Riding on a paved surface (OR: 0.63; 95% CI: 0.41-0.97) and utilitarian (school, work) bicycling (OR: 0.44; 95% CI: 0.2-0.94) decreased injury risk. Results were similar, apart from utilitarian bicycling (OR: 0.49; 95% CI: 0.22-1.06), after imputation for missing data.
Bicycle-MV collisions increase severe injury risk in youth, and adolescents are often injured in these events. This suggests separating bicyclists from MVs or traffic calming strategies could improve safety.
骑自行车是儿童和青少年运动及娱乐损伤的最常见原因；然而，关于与青少年严重自行车损伤相关因素的证据有限。
对2008年5月至2010年10月期间在7个急诊科就诊的18岁以下受伤自行车骑行者进行病例对照研究。病例为在急诊科就诊后住院的自行车骑行者（重伤）。对照为在急诊科就诊后被诊断并出院的自行车骑行者（非重伤）。通过访谈收集个人、环境和碰撞特征。从病历中收集损伤数据。使用逻辑回归的粗比值比（OR）和调整后的比值比以及95%置信区间（CI）来估计与危险因素相关的住院几率。采用多重填补技术处理缺失数据。
共有1470名参与者，其中119例为病例。13至17岁的青少年因机动车碰撞导致重伤的比例最高（23%）。在包含年龄、性别和机动车碰撞的模型中，男性（OR：2.02；95%CI：1.21 - 3.38）、未佩戴头盔（OR：2.18；95%CI：1.43 - 3.31）和机动车碰撞（OR：3.91；95%CI：2.26 - 6.78）是重伤的显著危险因素。在铺设路面骑行（OR：0.63；95%CI：0.41 - 0.97）和实用性骑行（上学、上班）（OR：0.44；95%CI：0.2 - 0.94）可降低受伤风险。在对缺失数据进行填补后，除实用性骑行（OR：0.49；95%CI：0.22 - 1.06）外，结果相似。
自行车与机动车碰撞会增加青少年的重伤风险，且青少年常在这些事故中受伤。这表明将自行车骑行者与机动车分隔开或采取交通 calming 策略可提高安全性。 （注：“交通 calming”直译为“交通缓和”，这里可能是一种特定的交通管理策略术语，具体含义需结合上下文和专业知识理解。）
