Half of Cyclists With Head Injuries Under 14

Wednesday, June 20, 2012

With National Bike Week getting under way it is worth bearing in mind that this healthy and safe activity also has its risks which is why it is important to wear a helmet.

Head injuries are the most common injury recorded in those admitted to hospital following an accident or crash involving a cyclist. Most deaths involving cyclists also involve head injuries.


Legislation has been introduced in many countries to make it compulsory to wear helmets. However, many still do not wear helmets.  There is some concern that making helmet wearing mandatory puts some people off cycling and some argue that the overall potential health benefits of cycling may be reduced as a result.
However, research supports the use of a correctly fitted bicycle helmet to reduce the risk of bicycle-related head injuries. The report below was supplied to me at a recent HSE Forum meeting.


Pedal Cyclists Hospitalised Following Road Traffic Crashes  2005-2009

Further to the report Admission to Acute Hospitals for Injuries as a Result of Road Traffic Collisions in Ireland, 2005-2009” the following data provide more information on pedal cyclists admitted to hospital during the same study period with particular reference to head injuries. Information is also presented in respect of head injuries and use of helmets.
Annual Numbers
During 2005-2009, there were 1,050 hospital discharges relating to pedal cyclists injured in road traffic crashes. Table 1 details the numbers of hospital discharges per year. The numbers of pedal cyclist discharges increased by 44% from 169 in 2005 to 244 in 2009.

Table 1: Annual number of pedal cyclists discharged from hospital with injuries resulting
                from traffic accidents, 2005-2009
Year
Number
%
2005
169
16.1
2006
210
20.0
2007
230
21.9
2008
197
18.8
2009
244
23.2
Total
1050
100.0

Age Profile
Three quarters (74.6%; n=783) of the injured were male, and one quarter (25.4%; n=267) were female. The average age of injured pedal cyclist was 25 years, with 50% of them aged less than 20 years. Figure 1 details an age profile of the injured pedal cyclists.

Figure 1: Age profile of the injured pedal cyclists by 5-year age-groups
In respect of those who suffered from head injuries, the average age was 22 years with 50% being aged 14 years or less. Figure 2 details an age profile of those with head injuries.

Figure 2: Age profile of those cyclists with head injuries  by 5-year age-groups

Principal Diagnosis
Table 2 details the principal diagnosis recorded among this group of injured pedal cyclists with injuries to the head were the most common (36.9%) followed by injuries to the elbow and forearm (21.7%).

Table 2: Principal diagnosis of hospitalised pedal cyclists
Principal Diagnosis
Number
%
Injuries to the Head
387
36.9
Injuries to the elbow & forearm
228
21.7
Injuries to the knee & lower leg
107
10.2
Injuries to the shoulder and upper-arm
81
7.7
Injuries to the abdomen, lower back, lumbar spine and pelvis
64
6.1
Injuries to the hip & thigh
58
5.5
Injuries to the wrist & hand
41
3.9
Injuries to the thorax
33
3.1
Injuries to the neck
15
1.4
Injuries to the ankle & foot
<5
0.4
Other diagnoses
32
3.0
Total
1050
100.0

Length of Hospital Stay
Pedal cyclists had an average length of stay of 4.7 days, with 70% of them having a length of stay of 1-2 days. Overall, 6.6% (n=69) required admission to intensive care, where their median length of stay was four days.

Three hundred and eighty seven cyclists had head injuries. They had an average length of stay of 4.5 days and 61% had a length of stay of 1-2 days.

Of the 387 cyclists admitted with head injuries, 46 were admitted to intensive care (11.9%). These patients had an average length of stay in intensive care of 8.5 days.

Discharge Outcome
Table 3 details the discharge destination of the injured pedal cyclists following hospital discharge. Overall, over 90% (n=954) of discharges were discharged directly home following their hospital episode. Sixty-six (6.3%) required transfer to another acute hospital on both emergency and non-emergency basis. There were thirteen (1.2%) deaths; all these deaths occurred within 30 days of admission.

Table 3: Discharge destination following hospital discharge 
Discharge Destination
Number
%
Home
944
89.9
Transfer to acute hospital as Non-Emergency
39
3.7
Transfer to acute hospital as Emergency
27
2.6
Died
13
1.2
Nursing home, convalescent home, long-stay
12
1.1
Self-discharge
10
1.0
Other
5
0.5

In respect of those admitted with head injuries, 340 (87.9%) were discharged home, 34(8.8%) were transferred to another hospital and 10(2.6%) died in hospital.

Cycling, Head Injuries and the Use of Helmet

A Cochrane review concluded that wearing a helmet reduced the risk of head injury by approximately two-thirds of crashes involving cyclists. The risk is reduced for all ages. Although there were no randomised control trials available for this review, the review included five well conducted case-control studies and found that helmets provide a 63–88% reduction in the risk of head, brain and severe brain injury for all ages of cyclists. Numerous other small studies show that wearing a helmet reduces head injuries.

See also here from the Irish Times


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