TY - JOUR
T1 - Helmet use is associated with safer bicycling behaviors and reduced hospital resource use following injury
AU - Webman, Rachel
AU - Dultz, Linda A.
AU - Simon, Ronald J.
AU - Todd, S. Rob
AU - Slaughter, Dekeya
AU - Jacko, Sally
AU - Bholat, Omar
AU - Wall, Stephen
AU - Wilson, Chad
AU - Levine, Deborah A.
AU - Roe, Matthew
AU - Pachte, H. Leonr
AU - Frangos, Spiros G.
PY - 2013/11
Y1 - 2013/11
N2 - BACKGROUND: While the efficacy of helmet use in the prevention of head injury is well described, helmet use as it relates to bicyclists' behaviors and hospital resource use following injury is less defined. The objective of this study was to compare the demographics, behaviors, hospital workups, and outcomes of bicyclists based on helmet use. METHODS: This study was a subset analysis of a 2.5-year prospective cohort study of vulnerable roadway users conducted at Bellevue Hospital Center, a NewYork City Level 1 trauma center. All bicyclists with known helmet statuswere included. Demographics, insurance type, traffic law compliance, alcohol use, Glasgow Coma Scale (GCS) score, initial imaging studies, Abbreviated Injury Scale (AIS) score, Injury Severity Score (ISS), admission status, length of stay, disposition, and mortality were assessed. Information was obtained primarily from patients; witnesses and first responders provided additional information. RESULTS: Of 374 patients, 113 (30.2%) were wearing helmets. White bicyclists were more likely to wear helmets; black bicyclists were less likely ( p = 0.037). Patients with private insurance were more likely to wear helmets, those with Medicaid or no insurance were less likely ( p = 0.027). Helmeted bicyclists were more likely to ride with the flow of traffic (97.2%) and within bike lanes (83.7%) (p < 0.001 and p = 0.013, respectively). Nonhelmeted bicyclists were more likely to ride against traffic flow ( p = 0.003). There were no statistically significant differences in mean GCS score, AIS score, and mean ISS for helmeted versus nonhelmeted bicyclists. Nonhelmeted patients were more likely to have head computed tomographic scans ( p = 0.049) and to be admitted ( p = 0.030). CONCLUSION: Helmet use is an indicator of safe riding practices, although most injured bicyclists do not wear them. In this study, helmet use was associated with lower likelihood of head CTs and admission, leading to less hospital resource use. Injured riders failing to wear helmets should be targeted for educational programs.
AB - BACKGROUND: While the efficacy of helmet use in the prevention of head injury is well described, helmet use as it relates to bicyclists' behaviors and hospital resource use following injury is less defined. The objective of this study was to compare the demographics, behaviors, hospital workups, and outcomes of bicyclists based on helmet use. METHODS: This study was a subset analysis of a 2.5-year prospective cohort study of vulnerable roadway users conducted at Bellevue Hospital Center, a NewYork City Level 1 trauma center. All bicyclists with known helmet statuswere included. Demographics, insurance type, traffic law compliance, alcohol use, Glasgow Coma Scale (GCS) score, initial imaging studies, Abbreviated Injury Scale (AIS) score, Injury Severity Score (ISS), admission status, length of stay, disposition, and mortality were assessed. Information was obtained primarily from patients; witnesses and first responders provided additional information. RESULTS: Of 374 patients, 113 (30.2%) were wearing helmets. White bicyclists were more likely to wear helmets; black bicyclists were less likely ( p = 0.037). Patients with private insurance were more likely to wear helmets, those with Medicaid or no insurance were less likely ( p = 0.027). Helmeted bicyclists were more likely to ride with the flow of traffic (97.2%) and within bike lanes (83.7%) (p < 0.001 and p = 0.013, respectively). Nonhelmeted bicyclists were more likely to ride against traffic flow ( p = 0.003). There were no statistically significant differences in mean GCS score, AIS score, and mean ISS for helmeted versus nonhelmeted bicyclists. Nonhelmeted patients were more likely to have head computed tomographic scans ( p = 0.049) and to be admitted ( p = 0.030). CONCLUSION: Helmet use is an indicator of safe riding practices, although most injured bicyclists do not wear them. In this study, helmet use was associated with lower likelihood of head CTs and admission, leading to less hospital resource use. Injured riders failing to wear helmets should be targeted for educational programs.
KW - Behavior
KW - Bicyclist
KW - Helmet
KW - Injury
UR - http://www.scopus.com/inward/record.url?scp=84890069869&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84890069869&partnerID=8YFLogxK
U2 - 10.1097/TA.0b013e3182a85f97
DO - 10.1097/TA.0b013e3182a85f97
M3 - Article
C2 - 24158210
AN - SCOPUS:84890069869
SN - 2163-0755
VL - 75
SP - 877
EP - 881
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
IS - 5
ER -