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

  • Jehane H. Dagher (a1) (a2), Camille Costa (a2), Julie Lamoureux (a3), Elaine de Guise (a4) (a5) and Mitra Feyz (a4)...

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.

Comparaison des conséquences d’un traumatisme crânien subi lors d’un accident de vélo avec ou sans port du casque. Objectif: Le but de l’étude était de déterminer si les conséquences sur la santé et si les caractéristiques démographiques des cyclistes diffèrent selon que le cycliste qui a subi un traumatisme crânien (TC) portait ou ne portait pas de casque. Méthode: Cette étude rétrospective porte sur 128 patients hospitalisés à l’Hôpital général de Montréal suite à un TC survenu à vélo entre 2007 et 2011. L’information a été recueillie du Fichier central des sinistres du Québec et du bureau du médecin légiste pour les cas de décès lors d’accidents de vélo. 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.

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Copyright

Corresponding author

Correspondence to: Jehane H. Dagher, Physical Medicine and Rehabilitation, McGill University Health Centre, Montreal General Hospital site, Room D13-124,1650 Cedar Avenue, Montreal, Quebec, H3G 1A4, Canada. E-mail: DrDagher@hotmail.com

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

  • Jehane H. Dagher (a1) (a2), Camille Costa (a2), Julie Lamoureux (a3), Elaine de Guise (a4) (a5) and Mitra Feyz (a4)...

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