Rowh Marta A W, Giller Taylor A, Bliton John N, Smith Randi N, Moran Tim P
Department of Emergency Medicine, Emory University, 531 Asbury Circle, Annex Building Suite N340, Atlanta, GA, 30322, USA.
Jamaica Hospital Medical Center, 8900 Van Wyck Expy, Richmond Hill, NY, 11418, USA.
Inj Epidemiol. 2025 Jan 24;12(1):7. doi: 10.1186/s40621-024-00558-6.
Cycling promotes health but carries significant injury risks, especially for older adults. In the U.S., cycling fatalities have increased since 1990, with adults over 50 now at the highest risk. As the population ages, the burden of cycling-related trauma is expected to grow, yet age-specific factors associated with mortality risk remain unclear. This study identifies age-specific mortality risk thresholds to inform targeted public health strategies.
We conducted a cross-sectional analysis of the National Trauma Data Bank (NTDB) data (2017-2023) on non-motorized cycling injuries. A total of 185,960 records were analyzed using logistic regression with splines to evaluate the relationship between age and mortality risk. The dataset was split into training (80%) and testing (20%) sets. Age thresholds where mortality risk changed were identified, and models were adjusted for injury severity, comorbidities, and helmet use.
The median patient age was 43 years (IQR 20-58). Four key age thresholds (12, 17, 31, and 69) were identified, with the largest mortality increase after age 69. Our model achieved an AUC of 0.93, surpassing traditional age cutoff models, with 84.6% sensitivity and 88.0% specificity.
Age is a significant predictor of mortality in cycling trauma, with marked increases in risk during adolescence and for adults over 69. These findings underscore the need for age-targeted interventions, such as improved cycling infrastructure for teens and enhanced safety measures for older adults. Public health initiatives should prioritize these vulnerable age groups to reduce cycling-related mortality.
骑自行车有益健康，但存在重大受伤风险，尤其是对老年人而言。在美国，自1990年以来，自行车骑行死亡人数有所增加，50岁以上的成年人目前面临的风险最高。随着人口老龄化，与自行车相关的创伤负担预计会增加，但与死亡风险相关的特定年龄因素仍不清楚。本研究确定了特定年龄的死亡风险阈值，以为有针对性的公共卫生策略提供依据。
我们对国家创伤数据库（NTDB）中2017 - 2023年的非机动车骑行损伤数据进行了横断面分析。使用带样条的逻辑回归分析了总共185,960条记录，以评估年龄与死亡风险之间的关系。数据集被分为训练集（80%）和测试集（20%）。确定了死亡风险发生变化的年龄阈值，并对模型进行了损伤严重程度、合并症和头盔使用情况的调整。
患者的年龄中位数为43岁（四分位距20 - 58岁）。确定了四个关键年龄阈值（12岁、17岁、31岁和69岁），69岁以后死亡率上升幅度最大。我们的模型曲线下面积（AUC）为0.93，超过了传统的年龄临界值模型，灵敏度为84.6%，特异度为88.0%。
年龄是自行车骑行创伤死亡率的重要预测因素，在青少年时期以及69岁以上成年人中风险显著增加。这些发现强调了针对特定年龄进行干预的必要性，例如改善青少年的自行车基础设施以及加强老年人的安全措施。公共卫生举措应优先关注这些易受影响的年龄组，以降低与自行车相关的死亡率。
