From the Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine.
Division of Trauma/Acute Care Surgery/Surgical Critical Care, LA County Harbor-UCLA Medical Center, Torrance, CA.
Pediatr Emerg Care. 2022 Jan 1;38(1):e360-e364. doi: 10.1097/PEC.0000000000002290.
Only 21 states have mandatory helmet laws for pediatric bicyclists. This study sought to determine the incidence of helmeted riders among pediatric bicyclists involved in a collision and hypothesized the risk of a serious head and cervical spine injuries to be higher in nonhelmeted bicyclists (NHBs) compared with helmeted bicyclists (HBs).
The Pediatric Trauma Quality Improvement Program (2014-2016) was queried for pediatric (age <16 years) bicyclists involved in a collision. Helmeted bicyclists were compared with NHBs. A serious injury was defined by an abbreviated injury scale grade of greater than 2.
From 3693 bicyclists, 3039 (82.3%) were NHBs. Compared with HBs, NHBs were more often Black (21.6% vs 3.8%, P < 0.001), Hispanic (17.5% vs 9.3%, P < 0.001), without insurance (4.6% vs 2.4%, P = 0.012), and had a higher rate of a serious head injury (24.6% vs 9.3%, P < 0.001). Both groups had similar rates of complications and mortality (P > 0.05). The associated risk of a serious head (odds ratio = 3.17, P < 0.001) and spine injury (odds ratio = 0.41, P = 0.012) were higher and lower respectively in NHBs. Associated risks for cervical spine fracture or cord injury were similar (P > 0.05).
Pediatric bicyclists involved in a collision infrequently wear helmets, and NHBs was associated with higher risks of serious head injury. However, the associated risk of serious spine injury among NHBs was lower. The associated risks for cervical spine fracture or cervical cord injuries were similar. Nonhelmeted bicyclists were more likely to lack insurance and to be Black or Hispanic. Targeted outreach programs may help decrease the risk of injury, especially in at-risk demographics.
只有 21 个州对儿童骑自行车者实施强制性头盔法。本研究旨在确定在碰撞中涉及的儿童自行车手戴头盔的发生率，并假设与戴头盔的自行车手 (HBs) 相比，不戴头盔的自行车手 (NHBs) 发生严重头部和颈椎损伤的风险更高。
查询了小儿创伤质量改进计划（2014-2016 年）中涉及碰撞的儿童（年龄 <16 岁）自行车手的数据。将戴头盔的自行车手与不戴头盔的自行车手进行比较。严重损伤定义为损伤严重程度评分大于 2 级。
在 3693 名自行车手，3039 名（82.3%）为不戴头盔的自行车手。与 HBs 相比，NHBs 更常为黑人（21.6%对 3.8%，P <0.001）、西班牙裔（17.5%对 9.3%，P <0.001）、无保险（4.6%对 2.4%，P =0.012），且发生严重头部损伤的几率更高（24.6%对 9.3%，P <0.001）。两组的并发症和死亡率相似（P >0.05）。不戴头盔的自行车手发生严重头部（比值比=3.17，P <0.001）和脊柱损伤（比值比=0.41，P =0.012）的风险更高，发生颈椎骨折或脊髓损伤的风险更低（比值比=0.41，P =0.012）。颈椎骨折或颈髓损伤的相关风险相似（P >0.05）。
在碰撞中涉及的儿童自行车手很少戴头盔，而不戴头盔的自行车手与严重头部受伤的风险更高相关。然而，不戴头盔的自行车手发生严重脊柱损伤的风险较低。颈椎骨折或颈髓损伤的相关风险相似。不戴头盔的自行车手更可能没有保险，并且更可能是黑人或西班牙裔。有针对性的外展计划可能有助于降低受伤风险，尤其是在高危人群中。
