Background Bicycling is an increasingly popular recreation and mode of transportation in korea. Head injury is the leading cause of death and permanent disability in bicycle-related crashes. So, the bicycle helmet is crucial protective equipment for bicyclists.
Aims This study aimed to measure the protective effects of bicycle helmet use on intracranial injury, in-hospital mortality and clinical important injury in bicycle-related crashes.
Methods This is a cross-sessional study based on the Emergency Department(ED)-based Injury In-depth Surveillance(EDIIS) database from 23 EDs in Korea. All of injured bicyclists between January 1, 2011. and December 31, 2016. were eligible, excluding cases with unknown helmet use and outcomes. The primary outcome was intracranial injury and the secondary outcomes were in-hospital mortality and clinical important injury (admission or in-hospital death). We calculated adjusted odds ratios (AORs) of helmet use for study outcomes after adjusting for potential confounders.
Results Among 24,306 eligible patients, 2,547(10.5%) patients were wearing helmets at the time of injury. 910(3.7%) patients had intracranial injuries, 198(0.8%) patients had in-hospital death and 3,745(15.4%) had clinical important injury. The helmeted group was less likely to have a injury in Head & Face(37.9% vs 47.1, p<0.05) but more likely to have a injury in Neck(4.7% vs 2.9%, p<0.05) compared to un-helmeted group. In the multivariable logistic regression models, the helmeted group was less likely to have intracranial injury(1.7% vs 4.0%, AOR: 0.39(0.28–0.53), in-hospital mortality (0.4% vs 0.9%, AOR: 0.37 (0.19–0.73) and clinical important injury (13.7% vs 15.6%, AOR: 0.74 (0.65–0.84).
Discussion and conclusions Wearing helmets in bicycle-related crashes had a significant preventive effects to reduce intracranial injury, in-hospital mortality and clinical important injury. But the rate of wearing helmet was very low. Public health efforts to increase bicycle helmet use are needed to reduce health burden from Injuries caused by bicycle crashes.
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