Injury patterns and outcomes following pediatric bicycle accidents.
OBJECTIVE
Other than automobiles, bicycles are connected to more pediatric injuries than any other consumer product. Whereas characterization of injury patterns following motor vehicle accidents has led to safety initiatives and treatment guidelines, knowledge related to bicyclist injuries is lacking. Our purpose is to identify major injury patterns and outcomes associated with pediatric bicycle accidents.


METHODS
From January 2000 to December 2012, 1934 consecutive pediatric admissions (≤17 years) at a level I trauma center were retrospectively reviewed for mechanism injury, demographics, and outcomes. Parametric data were analyzed with student's t test and are presented as mean ± standard deviation. Nonparametric data were analyzed with Mann-Whitney-U test and are presented as median (interquartile range). Analysis was performed to recognize injury patterns and outcomes significantly associated with bicycle related accidents.


RESULTS
80 pediatric patients were admitted following bicycle related trauma (4% of all pediatric trauma admissions). The cohort was age 11 ± 4 years, ISS 11 ± 10, 48% black, and 81% male. Injury patterns included 21% isolated head, 21% isolated abdominal, 13% isolated extremity, and 34% multiple injuries. 5% were age 0-4 years, 35% were age 5-9 years, 45% were 10-14 years, and 15% were 15-17 years (p < 0.001). 16% required operative intervention (6% abdominal, 9% orthopedic, 1% vascular). Children under age 6 required an abdominal operation 20% of the time. Length of stay was 2 (4) days with a mortality of 2.5%.


CONCLUSIONS
Pediatric bicycle accidents more commonly occur in male children aged 10-14 years. Orthopedic injury is the most frequent overall indication for surgery, yet the youngest children more often required an abdominal operation.


METHODS
Level III.
Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 450K, Miami, FL, 33136, USA.
Laura F
LF
Teisch
Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 450K, Miami, FL, 33136, USA.
Casey J
CJ
Allen
Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 450K, Miami, FL, 33136, USA.
Jun
J
Tashiro
Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 450K, Miami, FL, 33136, USA.
Samuel
S
Golpanian
Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 450K, Miami, FL, 33136, USA.
David
D
Lasko
Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 450K, Miami, FL, 33136, USA.
Nicholas
N
Namias
Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 450K, Miami, FL, 33136, USA.
Holly L
HL
Neville
Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 450K, Miami, FL, 33136, USA. jsola@med.miami.edu.
Juan E
JE
Sola
D000007:Abdominal Injuries / Q000453:epidemiology*; D000293:Adolescent; D017677:Age Distribution; D001642:Bicycling / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D006259:Craniocerebral Trauma / Q000453:epidemiology*; D005121:Extremities / Q000293:injuries*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009104:Multiple Trauma / Q000453:epidemiology*; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D017678:Sex Distribution; D014193:Trauma Centers / Q000706:statistics & numerical data
Bikes; Child safety; Children; Helmets; Injury prevention; Kids