Elsevier

Annals of Emergency Medicine

Volume 30, Issue 3, September 1997, Pages 260-265
Annals of Emergency Medicine

Bicycle-related Injuries Among Preschool Children,☆☆,

Presented in part at the Ambulatory Pediatric Association Annual Meeting, Washington DC, May 1993.
https://doi.org/10.1016/S0196-0644(97)70159-8Get rights and content

Abstract

Study objective: To describe the circumstances, severity, and outcome of bicycle-related injuries among hospitalized children younger than 5 years and to compare injuries in young children (<5 years) and older children (5 to 14 years). Methods: We studied a case series of children (0 to 14 years) with bicycle-related injuries requiring hospital admission reported to the National Pediatric Trauma Registry (NPTR) between January 1986 and June 1996. Results: Bicycle-related injuries were reported for 4,041 patients; 219 (5%) involved children younger than 5 years. Two young children and 124 older children (3%) wore bicycle helmets. Young children were less likely than older ones to be injured in the street (46% versus 81%, P<.001) and were more likely to be injured at home in the driveway or yard (39% versus 9%, P<.001). Interaction with a motor vehicle contributed to injuries in 31% of young children and 47% of older children (P<.001). Forty-five percent of young children and 56% of older children sustained head injuries (P<.002). The fractions of children in each age group with facial trauma, abdominal or thoracic injury, and fractures were similar. Pediatric Trauma Scores, Glasgow Coma Scale scores, operating room use rates, and median number of hospital days were similar for both age groups. Rehabilitation or extended care was required by 1% of young children and 2% of older children. Two deaths occurred among young children (1%); 2% of older children died. Conclusion: Of patients with bicycle-related injuries reported to the NPTR, a minority are young children, but they have injuries similar in severity and outcome to those of older children. Because young children sustain severe injuries, including head trauma, helmets are indicated for them, as well as for older children. [Powell EC, Tanz RR, DiScala C: Bicycle-related injuries among preschool children. Ann Emerg Med September 1997;30:260-265.]

Section snippets

INTRODUCTION

Injuries associated with bicycle riding are common in childhood. School-age children and adolescents seem to be at greatest risk, and injury-prevention efforts are often directed at them.1, 2, 3, 4, 5 Preschool children also ride bicycles. It is estimated that 200,000 to 300,000 bicycles are sold each year for use by preschool-age children (personal communication, M Pippen, Schwinn Bicycle Company, February 1994). However, information concerning bicycle-related injuries among these young

MATERIALS AND METHODS

Data on bicycle-related injuries to children aged 0 to 14 years were obtained from the National Pediatric Trauma Registry (NPTR) for the period January 1986 through June 1996. The NPTR is a multiinstitution database designed to record epidemiologic, demographic, and anatomic information on pediatric trauma.9 The participating centers include hospitals with pediatric trauma units and children's hospitals with trauma centers. These institutions report only patients who are admitted to the

RESULTS

During the 5-year study period, 4,041 children with bicycle-associated injuries were reported to the NPTR. Two hundred nineteen children (5%) were younger than 5 years (preschool or young children). One hundred fifty-five injured young children (71%) were boys; 2,875 injured older children (75%) were boys (P=.1).

Very few children in either age group wore a bicycle helmet (Table 1), although data were missing in many cases. A motor vehicle was involved in 31% of the injuries to young children.

DISCUSSION

Cycling is the third most popular sporting activity in the United States, and it is often a family activity.24 However, the circumstances and types of injuries among preschool cyclists has not been well addressed. We undertook this study to describe bicycle-associated injuries in young children and to compare injuries among young children with those among older children. The data indicate that bicycle-related injuries in hospitalized young children were of severity and outcome similar to those

Acknowledgements

We thank Mark Donovan for his assistance in statistical analysis.

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    From the Divisions of Pediatric Emergency Medicine* and General Academic Pediatrics, Children's Memorial Hospital, and the Department of Pediatrics, Northwestern University Medical School,§ Chicago, IL; and the Research and Training Center in Rehabilitation and Childhood Trauma, Department of Rehabilitation Medicine, Tufts/New England Medical Center, Boston, MA.

    ☆☆

    Reprint no.47/1/83898

    Address for reprints: Elizabeth C Powell, MD, Division of Pediatric Emergency Medicine, Box 62, Children's Memorial Hospital, 2300 Children's Plaza, Chicago, IL 60614, 773-880-8245, Fax 773-880-8267

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