Using data from the National Pediatric Trauma Registry, this study examined the characteristics of bicycle-related head injury, factors related to the presence of head injury, and different outcomes of head injury up to the time of discharge. Of the 2,333 patients ages 0 to 14 years who were admitted to trauma centers because of bicycle-related injury during 1989 through 1992, more than one-half (54%) sustained head injury, predominantly concussions and skull fractures. With adjustment for age, sex, and motor vehicle involvement, children who had pre-existing mental disorders, who did not wear a helmet at the time of injury, or who were injured on roads had a significantly increased likelihood of sustaining head injuries. Patients with a head injury were four times as likely as patients with no head injury to be treated in intensive care units, and were almost twice as likely to develop complications. Head injury was associated with an increased risk of inhospital fatality and high prevalence rates of communication and behavior impairments at discharge. Although it is urgent to increase helmet use substantially by child bicyclists, special attention should be paid to high-risk groups, such as children with mental disorders and children who are likely to ride in traffic.
From the Department of Health Policy and Management (G.L., S.P.B., C.F.), Center for Injury Research and Policy, The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland, and the Department of Physical Medicine and Rehabilitation (C.DiS.), Research and Training Center in Rehabilitation and Childhood Trauma, New England Medical Center and Tufts University School of Medicine, Boston, Massachusetts.
This study was supported primarily by a grant from the George Snively Research Foundation and in part by Grant R49/CCR302486 from the Centers for Disease Control and Prevention to The Johns Hopkins Injury Prevention Center (S.P.B., C.F., and G.L.). Dr. Li was supported in part by a First Award from the National Institute on Alcohol Abuse and Alcoholism (R29AA09963-01). Dr. DiScala was supported by Grant H133B344 from the National Institute of Disability and Rehabilitation Research, U.S. Department of Education.
Address for reprints: Guohua Li, MD, DrPH, Center for Injury Research and Policy, The Johns Hopkins University, School of Hygiene and Public Health, 624 North Broadway, Baltimore, MD 21205.
