自行车创伤与酒精中毒。
Bicycle trauma and alcohol intoxication.
机构信息
The Department of Surgery, Division of Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
The Department of Surgery, Division of Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
出版信息
Int J Surg. 2015 Dec;24(Pt A):14-9. doi: 10.1016/j.ijsu.2015.10.013. Epub 2015 Oct 19.
INTRODUCTION
As bicycling has become more popular, admissions after bicycle trauma are on the rise. The impact of alcohol use on bicycle trauma has not been well studied. The aim of this study was to examine the effect of alcohol intoxication on injury burden following bicycle-related crashes.
METHODS
A retrospective review of trauma patients presenting to a Level I trauma center after bicycle-related crashes from January 2002 to December 2011 was conducted. Demographics, injury data, alcohol intoxication, helmet use, and clinical outcomes were reviewed. Blood alcohol level (BAL) was considered positive if >0.01 g/dL. Variables were compared between patients based on BAL: negative, 0.01-0.16 g/dL, and >0.16 g/dL.
RESULTS
During the 10 year study period, 563 patients met study criteria; mean age was 33.5 ± 16.5 years, 87% were male, and mortality was 1%. On average, bicycle crashes increased over the study period by 4.4 collisions per year. BAL was tested in 211 (38%) patients. Mean BAL was 0.24 g/dL, with 37% of these patients being intoxicated (BAL ≥ 0.010 g/dL). Intoxicated patients were significantly less likely to wear a helmet (4.7% vs. 22.2%, p = 0.002) and to be involved in motor vehicle crash (59.0% vs. 81.2%, p < 0.001). There was no difference noted in the injury burden including ISS ≥ 16 (14.3% vs. 19.5%, p = 0.335) and AIS Head ≥ 3 (17.9% vs. 21.8%, p = 0.502). When comparing patients according to their BAL, there was a decreasing risk of motor vehicle collision with increasing BAL (81.2% for undetected, 76.5% for BAL ≤ 0.16 g/dL and 54.1% for BAL >0.16 g/dL, p < 0.001). The risk for a severe head injury (AIS Head ≥ 3) was significantly lower in helmeted patients (8.4% vs. 15.8%, p = 0.035).
CONCLUSIONS
The incidence of bicycle-related crashes is increasing and more than a third of patients tested for alcohol after bicycle-related crashes are found to be intoxicated. The injury burden in intoxicated patients, including head trauma, was not different compared to non-intoxicated patients. In addition, the risk for a collision with a motor vehicle was significantly lower. Nonetheless, these patients rarely utilize a helmet. The findings from this study can be used for the development and implementation of preventive strategies to minimize the injury burden associated with bicycle crashes and intoxicated cyclists.
简介
随着自行车运动的普及，自行车创伤后的入院人数呈上升趋势。酒精使用对自行车创伤的影响尚未得到很好的研究。本研究旨在探讨自行车相关事故后酒精中毒对伤害负担的影响。
方法
对 2002 年 1 月至 2011 年 12 月期间因自行车相关事故到一级创伤中心就诊的创伤患者进行回顾性研究。回顾了人口统计学、损伤数据、酒精中毒、头盔使用和临床结果。如果 >0.01 g/dL，则认为血液酒精水平（BAL）为阳性。根据 BAL 将患者分为以下三组：阴性（<0.01 g/dL）、0.01-0.16 g/dL 和 >0.16 g/dL。
结果
在 10 年的研究期间，563 名患者符合研究标准；平均年龄为 33.5±16.5 岁，87%为男性，死亡率为 1%。平均而言，自行车事故每年增加 4.4 起。211 名（38%）患者进行了 BAL 检测。平均 BAL 为 0.24 g/dL，其中 37%的患者处于醉酒状态（BAL≥0.010 g/dL）。醉酒患者戴头盔的可能性明显较低（4.7% vs. 22.2%，p=0.002），且更有可能卷入机动车事故（59.0% vs. 81.2%，p<0.001）。醉酒患者的损伤负担，包括 ISS≥16（14.3% vs. 19.5%，p=0.335）和 AIS 头≥3（17.9% vs. 21.8%，p=0.502）没有差异。当根据 BAL 比较患者时，随着 BAL 的增加，机动车碰撞的风险呈下降趋势（未检测到的为 81.2%，BAL≤0.16 g/dL 的为 76.5%，BAL>0.16 g/dL 的为 54.1%，p<0.001）。戴头盔的患者严重头部损伤（AIS 头≥3）的风险显著降低（8.4% vs. 15.8%，p=0.035）。
结论
自行车相关事故的发生率正在上升，超过三分之一的自行车相关事故后接受酒精检测的患者被发现醉酒。与非醉酒患者相比，醉酒患者的损伤负担（包括头部创伤）没有差异。此外，与机动车发生碰撞的风险显著降低。尽管如此，这些患者很少使用头盔。本研究的结果可用于制定和实施预防策略，以最大限度地降低与自行车事故和醉酒自行车手相关的伤害负担。
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