FACTORS RELATED TO THE PRESENCE OF HEAD-INJURY IN BICYCLE-RELATED PEDIATRIC TRAUMA PATIENTS

Using data from the National Pediatric Trauma Registry, this study exa mined the characteristics of bicycle-related head injury, factors rela ted to the presence of head injury, and different outcomes of head inj ury up to the time of discharge. Of the 2,333 patients ages 0 to 14 ye ars who were admitted to trauma centers because of bicycle-related inj ury during 1989 through 1992, more than one-half (54%) sustained head injury, predominantly concussions and skull fractures. With adjustment for age, sex, and motor vehicle involvement, children who had pre-exi sting mental disorders, who did not wear a helmet at the time of injur y, or who were injured on roads had a significantly increased likeliho od of sustaining head injuries. Patients with a head injury were four times as likely as patients with no head injury to be treated in inten sive care units, and were almost twice as likely to develop complicati ons. Head injury was associated with an increased risk of inhospital f atality and high prevalence rates of communication and behavior impair ments at discharge. Although it is urgent to increase helmet use subst antially by child bicyclists, special attention should be paid to high -risk groups, such as children with mental disorders and children who are likely to ride in traffic.