Incidence and costs of bicycle-related traumatic brain injuries in the Netherlands

Scholten, Annemieke C.; Polinder, Suzanne; Panneman, M.J.M.; Beeck, Ed F. van; Haagsma, Juanita A.

doi:10.1016/j.aap.2015.04.022

Cited by 61 publications

(41 citation statements)

References 38 publications

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“…A previous study has shown that medical costs increase as the severity of trauma gets worse[13], and several studies have shown that bicycle-related injuries suffered by intoxicated riders are significantly associated with increases in severity of trauma and hospitalization or death[14, 15]. Similarly, intoxicated patients incur increased costs [8, 9].…”

Section: Discussionmentioning

confidence: 99%

Emergency department outpatient treatment of alcohol-intoxicated bicyclists increases the cost of medical care in Japan

Homma¹,

Yamauchi

Mizobe³

et al. 2017

PLoS ONE

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Riding a bicycle under the influence of alcohol is illegal in Japan. Nevertheless, intoxicated bicyclists are frequently treated at hospital emergency departments for bicycle-related injuries. This patient population usually requires more hospital resources, even for relatively minor injuries. Therefore, we hypothesized that bicycle-related crashes involving bicyclists under the influence of alcohol cost more to treat than those that do not involve alcohol intoxication. The aim of the present study was to examine the costs associated with bicycle-related minor injuries and alcohol intoxication of the bicyclist. The study was conducted at the Tokyo Bay Urayasu Ichikawa Medical Center Emergency Department, Japan. All minor bicycle crashes involving 217 individuals aged ≥20 years treated from September 1, 2012 to August 31, 2013 were included in the analysis of data obtained from medical records. Variables included alcohol intoxication, sex, age, collision with a motor vehicle, Glasgow Coma Scale, injury severity score (ISS), laboratory tests, treatment of wounds, number of X-ray images, number of computed tomography scans, and medical costs. Multiple linear regression analysis was performed to evaluate the association between alcohol intoxication and medical costs. Seventy (32%) patients consumed alcohol, and the median medical cost was 253 USD (interquartile range [IQR], 164–330). Multivariable analysis showed that alcohol intoxication was independently associated with higher medical costs (p = 0.030, adjusted R-square value = 0.55). These findings support our hypothesis and should encourage authorities to implement comprehensive measures to prohibit bicycling under the influence of alcohol to prevent injuries and to reduce medical costs.

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Section: Discussionmentioning

confidence: 99%

Emergency department outpatient treatment of alcohol-intoxicated bicyclists increases the cost of medical care in Japan

Homma¹,

Yamauchi

Mizobe³

et al. 2017

PLoS ONE

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“…Traumatic brain injury (TBI) is the main cause of severe morbidity and mortality after an accident involving bicyclists. More specifically, 32% out of all hospitalized cyclists with severe injury has a head or brain injury [1,4,6]. The incidence of bicycle related TBI treated at the ED has increased with 54% between 1998 and 2012, while the overall incidence of bicycle related injuries treated at the ED remained relatively stable in that period.…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of bicycle related TBI treated at the ED has increased with 54% between 1998 and 2012, while the overall incidence of bicycle related injuries treated at the ED remained relatively stable in that period. In 2012, bicycle related TBI was treated 43 times per 100,000 persons in the ED and resulted in subsequent hospitalization in 64% of the TBI cases [6].…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of mandatory bicycle helmet use to prevent traumatic brain injuries and death

et al. 2020

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Background: Traumatic brain injury (TBI) is the main cause of mortality and severe morbidity in cyclists admitted to Dutch emergency departments (EDs). Although the use of bicycle helmets is an effective way of preventing TBI, this is uncommon in the Netherlands. An option to increase its use is through a legal enforcement. However, little is known about the cost-effectiveness of such mandatory use of helmets in the Dutch context. The current study aimed to assess the cost-effectiveness of a law that enforces helmet use to reduce TBI and TBIrelated mortality. Methods: The cost-effectiveness was estimated through decision tree modelling. In this study, wearing bicycle helmets enforced by law was compared with the current situation of infrequent voluntary helmet use. The total Dutch cycling population, consisting of 13.5 million people, was included in the model. Model data and parameters were obtained from Statistics Netherlands, the National Road Traffic Database, Dutch Injury Surveillance System, and literature. Effects included were numbers of TBI, death, and disability-adjusted life years (DALY). Costs included were healthcare costs, costs of productivity losses, and helmet costs. Sensitivity analysis was performed to assess which parameter had the largest influence on the incremental cost-effectiveness ratio (ICER). Results: The intervention would lead to an estimated reduction of 2942 cases of TBI and 46 deaths. Overall, the incremental costs per 1) death averted, 2) per TBI averted, and 3) per DALY averted were estimated at 1) € 2,002,766, 2) € 31,028 and 3) € 28,465, respectively. Most favorable were the incremental costs per DALY in the 65+ age group: € 17,775. Conclusions: The overall costs per DALY averted surpassed the Dutch willingness to pay threshold value of € 20, 000 for cost-effectiveness of preventive interventions. However, the cost per DALY averted for the elderly was below this threshold, indicating that in this age group largest effects can be reached. If the price of a helmet would reduce by 20%, which is non-hypothetical in a situation of large-scale purchases and use of these helmets, the introduction of this regulation would result in an intervention that is almost cost-effective in all age groups.

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“…3 In the Netherlands, where per capital bicycle ownership is as high as one which is the highest in the world, 456 bicycle-related injuries per 100 thousand people were reported in 2012. 4 Helmet wearing is considered an effective measure to prevent bicycle-related injuries. Research has been conducted to investigate its protective effects on various injury types including head, brain, face, and neck injuries taking other kinds of injuries as controls.…”

Section: Introductionmentioning

confidence: 99%

Cumulative evidence of helmet effects on bicycle injuries

Chen¹,

Shan

Cui³

et al. 2020

Preprint

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Background: With the wide use of bicycles, studies of helmet effects on bicycle injuries were intensively conducted after the problem of bicycle injuries emerged. This study aims to justify whether current evidence is sufficient to support the effects of helmets.Methods：We exhaustively searched the articles in the databases of Medline, Scopus, and Embase by the term of (helmet* AND (cycl* OR bicycle* OR bike*)) AND injur* by the time of April 10, 2019. The meta-analysis and SSA (study sequential analysis) were conducted. The protocol was registered in Prospero (www.crd.york.ac.uk/PROSPERO/, ID: CRD42019131751). Results: A total of 55 studies were eligible for meta-analysis. The OR (odds ratio) of helmet effect on head injuries compared with other injuries was 0·50 (0·43, 0·59) and effects of helmets on serious head injuries compared with other injuries were protective with an OR of 0·34 (0·28, 0·43). Compared with control injuries, the OR of helmets’ effects on facial injuries is 0·63 (0·45, 0·88). Helmets were not associated with protective effects with regards to neck injuries and the OR was 0·98 (0·82, 1·17). SSA results of head injuries, serious head injuries, and face injuries showed the cumulative Z-curve crossed both the conventional and the trial sequential monitoring boundary. SSA results of neck injuries showed the cumulative Z-curve does not cross both the conventional and the trial sequential monitoring boundary.Conclusions: The helmet has protection effects on head injuries, serious head injuries, and face injuries. The SSA showed the current evidence was sufficient to support the results. More studies of helmet promotion are warranted in the future.

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Incidence and costs of bicycle-related traumatic brain injuries in the Netherlands

Cited by 61 publications

References 38 publications

Emergency department outpatient treatment of alcohol-intoxicated bicyclists increases the cost of medical care in Japan

Emergency department outpatient treatment of alcohol-intoxicated bicyclists increases the cost of medical care in Japan

Cost-effectiveness of mandatory bicycle helmet use to prevent traumatic brain injuries and death

Cumulative evidence of helmet effects on bicycle injuries

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