Comparative Outcomes of Traumatic Brain Injury from Biking Accidents With or Without Helmet Use

Abstract

Objective: To determine if health outcomes and demographics differ according to helmet status between persons with cycling-related traumatic brain injuries (TBI). Methods: This is a retrospective study of 128 patients admitted to the Montreal General Hospital following a TBI that occurred while cycling from 2007-2011. Information was collected from the Quebec trauma registry and the coroner's office in cases of death from cycling accidents. The independent variables collected were socio-demographic, helmet status, clinical and neurological patient information. The dependent variables evaluated were length of stay (LOS), extended Glasgow outcome scale (GOS-E), injury severity scale (ISS), discharge destination and death. Results: 25% of cyclists wore a helmet. The helmet group was older, more likely to be university educated, married and retired. Unemployment, longer intensive care unit (ICU) stay, severe intracranial bleeding and neurosurgical interventions were more common in the no helmet group. There was no significant association between the severity of the TBI, ISS scores, GOS-E or death and helmet wearing. The median age of the subjects who died was higher than those who survived. Conclusion: Cyclists without helmets were younger, less educated, single and unemployed. They had more severe TBIs on imaging, longer LOS in ICU and more neurosurgical interventions. Elderly cyclists admitted to the hospital appear to be at higher risk of dying in the event of a TBI. Les variables indépendantes recueillies étaient les données sociodémographiques, le port du casque, l'information clinique et neurologique. Les variables indépendantes étaient la durée du séjour hospitalier, le score à l'échelle de devenir de Glasgow étendue (GOS-E), le score à l'ISS (injury severity scale), la destination au moment du congé hospitalier et le décès. Résultats: Vingt-cinq pour cent des cyclistes portaient un casque. Le groupe de patients qui portaient un casque était plus âgé, plus susceptible d'avoir un niveau de scolarité universitaire, d'être marié et d'être à la retraite. Le chômage, un séjour prolongé à l'unité de soins intensifs (USI), un saignement intracrânien plus sévère et un traitement neurochirurgical étaient plus fréquemment présents dans le groupe de cyclistes qui ne portaient pas de casque. Il n'y avait pas d'association significative entre la sévérité du TC, les scores ISS, GOS-E ou le décès et le port du casque. L'âge médian des sujets qui sont décédés était plus élevé que celui des survivants. Conclusion: Les cyclistes qui ne portaient pas de casque étaient plus jeunes, moins instruits, plus fréquemment célibataires et sans emploi. Ils avaient un TC plus sévère à l'imagerie, ils ont été hospitalisés à l'USI plus longtemps et ils ont subi plus d'interventions neurochirurgicales. Le risque de décès était plus élevé chez cyclistes plus âgés qui ont été hospitalisés suite à un TC.

A Multifactorial Approach to Sport-Related Concussion Prevention and Education: Application of the Socioecological Framework

“…Helmets are the most discussed piece of concussion-related protective equipment, and they reduce the risk of moderate to severe brain injury in cycling. 57 However, the literature is not clear on their ability to prevent concussion in contact-sport athletes. 58 Ongoing research is targeting the development of helmet materials that may reduce the concussion risk.…”

Análisis de las lesiones causadas por el tránsito sufridas por ciclistas en México

“…El uso de casco en ciclistas lesionados en México fue significativamente menor que lo reportado previamente en Alberta o Montreal(Canadá), donde el 26% de las personas fallecidas y el 25% de los ciclistas que presentaron TCE, respectivamente, lo llevaban puesto 13,14 . El casco es una intervención dirigida a la protección del ciclista.…”

Head and face injuries among cyclists admitted to the Craniomaxillofacial and Oncological Department at the Medical University of Lodz

“…On the other hand, they found that helmeted cyclist had a higher risk of polytrauma. 9 Many studies still confirm the protective effects of helmets in the case of head and face injuries. [28][29][30] Amoros et al claimed that cyclists with helmets were more frequently involved in collisions with pedestrians or bicycles and had a higher appearance of coexisting injuries in regions other than the head and face, which is similar to our results.…”

“…9,10 But on the other hand, there is no association between helmet use and the risk of facial injuries. Also, they do not protect the lower facial region.…”