European Journal of Trauma and Emergency Surgery

, Volume 40, Issue 6, pp 729–732

Rethinking bicycle helmets as a preventive tool: a 4-year review of bicycle injuries

  • B. Joseph
  • V. Pandit
  • B. Zangbar
  • M. Amman
  • M. Khalil
  • T. O’Keeffe
  • T. Orouji
  • A. Asif
  • A. Katta
  • D. Judkins
  • R. S. Friese
  • P. Rhee
Original Article

DOI: 10.1007/s00068-014-0453-0

Cite this article as:
Joseph, B., Pandit, V., Zangbar, B. et al. Eur J Trauma Emerg Surg (2014) 40: 729. doi:10.1007/s00068-014-0453-0

Abstract

Introduction

Traumatic brain injury is a leading cause of disability in bicycle riders. Preventive measures including bicycle helmet laws have been highlighted; however, its protective role has always been debated. The aim of this study was to determine the utility of bicycle helmets in prevention of intra-cranial hemorrhage. We hypothesized that bicycle helmets are protective and prevent the development of intra-cranial hemorrhage.

Methods

We performed a 4-year (2009–2012) retrospective cohort analysis of all the patients who presented with traumatic brain injury due to bicycle injuries to our level 1 trauma center. We compared helmeted and non-helmeted bicycle riders for differences in the patterns of injury, need for intensive care unit admissions and mortality.

Results

A total of 864 patients were reviewed of which, 709 patients (helmeted = 300, non-helmeted = 409) were included. Non-helmeted bicycle riders were more likely to be young (p < 0.001) males (p = 0.01). There was no difference in the median ISS between the two groups (p = 0.3). Non-helmeted riders were more likely to have a skull fracture (p = 0.01) and a scalp laceration (p = 0.01) compared to the helmeted riders. There was no difference in intra-cranial hemorrhage between the two groups (p = 0.1). Wearing a bicycle helmet was not independently associated (p = 0.1) with development of intra-cranial hemorrhage.

Conclusion

Bicycle helmets may have a protective effect against external head injury but its protective role for intra-cranial hemorrhage is questionable. Further studies assessing the protective role of helmets for intra-cranial hemorrhage are warranted.

Keywords

Helmet laws Traumatic brain injury Bicycle injury 

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • B. Joseph
    • 1
  • V. Pandit
    • 1
  • B. Zangbar
    • 1
  • M. Amman
    • 1
  • M. Khalil
    • 1
  • T. O’Keeffe
    • 1
  • T. Orouji
    • 1
  • A. Asif
    • 1
  • A. Katta
    • 1
  • D. Judkins
    • 1
  • R. S. Friese
    • 1
  • P. Rhee
    • 1
  1. 1.Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of SurgeryUniversity of ArizonaTucsonUSA

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