Senturia Y D, Morehead T, LeBailly S, Horwitz E, Kharasch M, Fisher J, Christoffel K K
Department of Pediatrics, Children's Memorial Medical Center, Northwestern University, Chicago, Ill., USA.
Arch Pediatr Adolesc Med. 1997 May;151(5):485-9. doi: 10.1001/archpedi.1997.02170420055009.
To identify bicycle-riding circumstances associated with bicycle-related injury among school-aged children.
Case-control.
One metropolitan emergency department and 3 suburban emergency departments.
Consecutive sample of children aged 7 through 18 years who experienced bicycle-related trauma and control children seen for non-bicycle-related trauma (matched for age within 1 year, sex, and area of residence [urban vs suburban]).
Parents and case children were interviewed by telephone about the bicycle ride resulting in their visit to the emergency department. Parents and control children were interviewed about their most recent bicycle ride. The survey instrument addressed the following potential risk factors: helmet use, bicycle speed, road conditions, riding location, bicycle condition, an adult presence, riding destination, bicycle style, and stunt riding.
Interviews were completed with 47 (73%) of 64 eligible case children and 42 (69%) of 61 control children with the following age distribution: 27 (30%) of the interviews were completed with children aged 7 to 9 years, 40 (45%) of the interviews were completed with children aged 10 to 14 years, and 22 (25%) of the interviews were completed with children aged 15 to 18 years. Fourteen children (16%) were wearing helmets. There was a high degree of agreement between parent and child responses, higher for case children than for control children. In univariate analyses, injury was associated with riding with other children (vs riding alone or with adults), riding fast or slow (vs normal speed), riding a BMX-style (motocross) bicycle (vs another standard or multispeed style bicycle), playing on the bicycle (vs going to school or other purposeful or nonpurposeful trip), and riding only on the sidewalk (vs in the street). More case children than control children were farther than 3/4 mile (> 1.2 km) from home (38% vs 19%, P = .05). Multiple logistic regression identified' slow riding speed (odds ratio, 10.3;95% confidence interval, 1.6-66.8), distance from home farther than 3/4 mile (> 1.2 km) (odds ratio, 3.7;95% confidence interval, 1.1-12.5), and riding on the sidewalk (odds ratio, 6.1;95% confidence interval, 1.8-20.5) as independent risk factors for injury.
This study identifies 3 counterintuitive but apparently strong behavioral risk factors for bicycle injuries treated in an emergency department in children aged 7 through 18 years in the Chicago (III) area. These findings will need to be confirmed in larger samples from a wider range of locales. In addition to stressing the importance of wearing a helmet when riding a bicycle, it may be desirable to include the findings of this study in anticipatory guidance discussions with school-aged children.
确定学龄儿童中与自行车相关伤害有关的骑车情况。
病例对照研究。
一个大城市急诊科和3个郊区急诊科。
7至18岁经历过自行车相关创伤的儿童连续样本，以及因非自行车相关创伤就诊的对照儿童（按年龄在1岁以内、性别和居住地区[城市与郊区]匹配）。
通过电话采访病例儿童的父母，了解导致他们前往急诊科就诊的那次骑车情况。采访父母和对照儿童最近一次骑车的情况。调查工具涉及以下潜在危险因素：头盔使用情况、自行车速度、道路状况、骑行地点、自行车状况、是否有成人陪同、骑行目的地、自行车类型和特技骑行。
64名符合条件的病例儿童中有47名（73%）、61名对照儿童中有42名（69%）完成了访谈，年龄分布如下：27名（30%）访谈对象为7至9岁儿童，40名（45%）访谈对象为10至14岁儿童，22名（25%）访谈对象为15至18岁儿童。14名儿童（16%）佩戴了头盔。父母和儿童的回答高度一致，病例儿童的一致性高于对照儿童。在单因素分析中，受伤与和其他儿童一起骑车（与独自骑车或与成人一起骑车相比）、骑得快或慢（与正常速度相比）、骑BMX风格（越野）自行车（与其他标准或多速风格自行车相比）、在自行车上玩耍（与上学或其他有目的或无目的出行相比）以及仅在人行道上骑车（与在街上骑车相比）有关。病例儿童中离家超过3/4英里（>1.2公里）的比例高于对照儿童（38%对19%，P = 0.05）。多因素logistic回归确定“骑行速度慢（比值比，10.3；95%置信区间，1.6 - 66.8）、离家距离超过3/4英里（>1.2公里）（比值比，3.7；95%置信区间，1.1 - 12.5）以及在人行道上骑车（比值比，6.1；95%置信区间，1.8 - 20.5）为受伤的独立危险因素。
本研究确定了芝加哥（伊利诺伊州）地区7至18岁儿童在急诊科接受治疗的自行车伤害的3个违反直觉但显然很强的行为危险因素。这些发现需要在更广泛地区的更大样本中得到证实。除了强调骑自行车时佩戴头盔的重要性外，可能还需要将本研究的结果纳入与学龄儿童的预期指导讨论中。
