Carone Laura, Ardley Rohan, Davies Patrick
LNR Deanery, United Kingdom.
Sheffield Teaching Hospitals NHS Foundation Trust, United Kingdom.
Injury. 2019 Jan;50(1):61-64. doi: 10.1016/j.injury.2018.08.015. Epub 2018 Aug 20.
Traumatic injury is the leading cause of death in children after infancy. Almost 25% of all cyclists killed in the UK are children, and two thirds of these will die because of their head injuries. We compared the population of young people wearing helmets whilst cycling, to those admitted with serious post cycling head injuries to our paediatric critical care unit.
All children aged 0-18 years admitted to our intensive care following a bicycle accident between the years January 2011-June 2018 were identified and information on the mechanism of injury, and both immediate and long term clinical data were collected. For comparison data, helmet wearing on a random morning was observed from six schools. All pupils arriving at school by bicycle were observed. Data collected included the school year and sex of the child, and whether each child was wearing a helmet or not.
Of 28 cases, 22 were admitted due to head injuries. None wore a helmet. 23/133 school pupils wore a helmet. The intensive care population were significantly less likely to be wearing helmets than the general population (p = 0.044, Fisher's exact test). A Chi-Square test for helmet wearing by school year showed a reduction in helmet wearing with increasing school year with a p value of 0.0026. There was no association between helmet wearing and abdominal injury.
Young people admitted to a Critical Care Unit with cycling related head trauma are statistically significantly less likely to wear a helmet than the general, age matched cycling population. Helmet wearing decreases as children get older. Outcomes were mixed, but in the head trauma group only 3/18 recovered with no neurological deficit.
创伤性损伤是婴儿期后儿童死亡的主要原因。在英国，所有死于自行车事故的骑车人中，近25%是儿童，其中三分之二将因头部受伤而死亡。我们比较了骑自行车时戴头盔的年轻人与因严重的自行车骑行后头部受伤而入住我们儿科重症监护病房的人群。
确定了2011年1月至2018年6月期间因自行车事故入住我们重症监护病房的所有0至18岁儿童，并收集了损伤机制以及即时和长期临床数据。为了获取比较数据，在六个学校的一个随机早晨观察了头盔佩戴情况。观察了所有骑自行车上学的学生。收集的数据包括孩子的学年和性别，以及每个孩子是否戴头盔。
在28例病例中，22例因头部受伤入院。无人戴头盔。133名学生中有23人戴头盔。重症监护病房的人群戴头盔的可能性明显低于普通人群（p = 0.044，Fisher精确检验）。按学年进行的头盔佩戴情况卡方检验显示，随着学年增加，头盔佩戴率降低，p值为0.0026。头盔佩戴与腹部损伤之间无关联。
与因骑自行车相关的头部创伤而入住重症监护病房的年轻人相比，在统计学上，年龄匹配的普通骑自行车人群戴头盔的可能性明显更高。随着孩子年龄增长，头盔佩戴率下降。结果不一，但在头部创伤组中，只有18人中的3人康复且无神经功能缺损。
