An epidemiological analysis of injuries among cyclists and clinical characteristics of them: A single-center experience from Northwest of Iran

Document Type : Original Article

Authors

1 Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran

2 Road Traffic Injury Research Center; Student Research Committee; Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

3 Department of Epidemiology and Biostatistics, School of Health, Guilan University of Medical Sciences, Rasht, Iran

4 Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

5 Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran

6 Miyandoab Health Center, Urmia University of Medical Sciences, Urmia, Iran

7 Health Management and Economic Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran

8 Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

10.4103/atr.atr_69_21

Abstract

Background and Objectives: The most common cause of death and serious disability in cyclist's crashes is traumatic brain injury. The The present study aimed to provide accurate statistics and information on traffic accidents based on epidemiologic characteristics and outcomes of cyclists' injuries in East Azerbaijan province-Iran, based on International Classification of Diseases ICD-10 and International Classification of Diseases 9th Revision, Clinical Modification (ICD-9-CM) guidelines. Materials and Methods: This cross-sectional study was conducted in Tabriz, Iran, on 317 cyclists who sustained an injury through road traffic accidents. Multivariable Cox regression, reported as hazard ratios (95% confidence interval), quantified the association between explanatory variables such as age, gender, and anatomical regions with mortality. Results: The present study included 317 trauma patients with an average age of 34.72 (SD= 24.14) years old; 89.6% of the patients were male. Collision with truck or van, pick-up, and automobiles collisions (42.9%) were the most common counterpart vehicle used [V13]. The most common anatomical regions affected by the cyclists were head injuries (72.2%) (S00–S09). The highest proportion of injuries incurred by cyclists was superficial (46%) [S00-T00]. Closure of skin and subcutaneous tissue of other sites were the most clinical modification provided for the patients (54.1%) (86.59). The obtained regression coefficient showed that age increased the odds ratio of mortality by 0.02. Conclusions: Men were the most injured group. Head injuries were the most common injuries. Skin and subcutaneous tissue sutures commonly require surgery. Also, the chance of mortality increases with age. All cyclists need to wear a helmet to reduce head-impairing injuries.

Keywords

References

1.
Gopalakrishnan S. A public health perspective of road traffic accidents. Journal of family medicine and primary care 2012;1:144.  Back to cited text no. 1
    
2.
Clarke DD, Ward P, Bartle C, Truman W. Young driver accidents in the UK: The influence of age, experience, and time of day. Accident Analysis & Prevention 2006;38:871-8.  Back to cited text no. 2
    
3.
Rivara FP, Thompson DC, Thompson RS. Epidemiology of bicycle injuries and risk factors for serious injury. Inj Prev 1997;3:110-4.  Back to cited text no. 3
    
4.
Soori H. Epidemiology of children's cycling injuries in Ahwaz, Islamic Republic of Iran. East Mediterr Health J 2002;8:308-14.  Back to cited text no. 4
    
5.
Ghorbanali M. Road traffic fatalities among pedestrians, bicyclist s and motor vehicle occupants in Sirjan Kerman Iran. Chinese Journal of traumatology 2009;12:200-202.  Back to cited text no. 5
    
6.
Kaplan J, Thacker S. Working to Prevent and Control Injuries in the Year 2000: The Injury Fact Book for the Year 2000. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2000.  Back to cited text no. 6
    
7.
Güngör F, Oktay C, Topaktaş Z, Akçimen M. Analysis of motorcycle accident victims presenting to the emergency department. Ulus Travma Acil Cerrahi Derg 2009;15:390-5.  Back to cited text no. 7
    
8.
Kang YW, Lee SH, Park SC, Cho YM, Wang IJ, Bae BK, et al. Early predictors of severe injury in motorcycle crashes. J Korean Soc Emerg Med 2017;28:327-33.  Back to cited text no. 8
    
9.
Bambach MR, Mitchell RJ, Grzebieta RH, Olivier J. The effectiveness of helmets in bicycle collisions with motor vehicles: A case-control study. Accid Anal Prev 2013;53:78-88.  Back to cited text no. 9
    
10.
Attewell RG, Glase K, McFadden M. Bicycle helmet efficacy: A meta-analysis. Accid Anal Prev 2001;33:345-52.  Back to cited text no. 10
    
11.
Weiss BD. Nontraumatic injuries in amateur long distance bicyclists. Am J Sports Med 1985;13:187-92.  Back to cited text no. 11
    
12.
Cripton PA, Shen H, Brubacher JR, Chipman M, Friedman SM, Harris MA, et al. Severity of urban cycling injuries and the relationship with personal, trip, route and crash characteristics: Analyses using four severity metrics. BMJ Open 2015;5:e006654.  Back to cited text no. 12
    
13.
Wang C, Lu L, Lu J. Statistical analysis of bicyclists' injury severity at unsignalized intersections. Traffic Inj Prev 2015;16:507-12.  Back to cited text no. 13
    
14.
Hagel BE, Romanow NT, Enns N, Williamson J, Rowe BH. Severe bicycling injury risk factors in children and adolescents: A case-control study. Accid Anal Prev 2015;78:165-72.  Back to cited text no. 14
    
15.
Crocker P, Zad O, Milling T, Lawson KA. Alcohol, bicycling, and head and brain injury: A study of impaired cyclists' riding patterns R1. Am J Emerg Med 2010;28:68-72.  Back to cited text no. 15
    
16.
Sethi M, Heyer JH, Wall S, DiMaggio C, Shinseki M, Slaughter D, et al. Alcohol use by urban bicyclists is associated with more severe injury, greater hospital resource use, and higher mortality. Alcohol 2016;53:1-7.  Back to cited text no. 16
    
17.
Vanlaar W, Mainegra Hing M, Brown S, McAteer H, Crain J, McFaull S. Fatal and serious injuries related to vulnerable road users in Canada. J Safety Res 2016;58:67-77.  Back to cited text no. 17
    
18.
Kim JK, Kim S, Ulfarsson GF, Porrello LA. Bicyclist injury severities in bicycle-motor vehicle accidents. Accid Anal Prev 2007;39:238-51.  Back to cited text no. 18
    
19.
Boufous S, de Rome L, Senserrick T, Ivers R. Risk factors for severe injury in cyclists involved in traffic crashes in Victoria, Australia. Accid Anal Prev 2012;49:404-9.  Back to cited text no. 19
    
20.
Kaplan S, Vavatsoulas K, Prato CG. Aggravating and mitigating factors associated with cyclist injury severity in Denmark. J Safety Res 2014;50:75-82.  Back to cited text no. 20
    
21.
Molina-Soberanes D, Martínez-Ruiz V, Lardelli-Claret P, Pulido-Manzanero J, Martín-delosReyes LM, Moreno-Roldán E, et al. Individual and environmental factors associated with death of cyclists involved in road crashes in Spain: A cohort study. BMJ Open 2019;9:e028039.  Back to cited text no. 21
    
22.
Staunton CE, Hubsmith D, Kallins W. Promoting safe walking and biking to school: The Marin County success story. Am J Public Health 2003;93:1431-4.  Back to cited text no. 22
    
23.
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. Ann Intern Med 2007;147:573-7.  Back to cited text no. 23
    
24.
Cochran SD, Drescher J, Kismödi E, Giami A, García-Moreno C, Atalla E, et al. Proposed declassification of disease categories related to sexual orientation in the International Statistical Classification of Diseases and Related Health Problems (ICD-11). Bull World Health Organ 2014;92:672-9.  Back to cited text no. 24
    
25.
Kleinbaum DG, Klein M. Survival Analysis. New York: Springer; 2010.  Back to cited text no. 25
    
26.
Björnstig J, Bylund PO, Björnstig U. Vehicle-related injuries in and around a medium sized Swedish City – Bicyclist injuries caused the heaviest burden on the medical sector. Inj Epidemiol 2017;4:4.  Back to cited text no. 26
    
27.
Li G, Baker SP, Langlois JA, Kelen GD. Are female drivers safer? An application of the decomposition method. Epidemiology 1998;9:379-84.  Back to cited text no. 27
    
28.
Akar G, Fischer N, Namgung M. Bicycling choice and gender case study: The Ohio State University. Int J Sustain Transp 2013;7:347-65.  Back to cited text no. 28
    
29.
Useche S, Montoro L, Alonso F, Oviedo-Trespalacios O. Infrastructural and Human Factors Affecting Safety Outcomes of Cyclists. Sustainability 2018;10:299-300.  Back to cited text no. 29
    
30.
Scott-Parker B, Watson B, King MJ, Hyde MK. Mileage, car ownership, experience of punishment avoidance, and the risky driving of young drivers. Traffic Inj Prev 2011;12:559-67.  Back to cited text no. 30
    
31.
Martínez-Ruiz V, Jiménez-Mejías E, Amezcua-Prieto C, Olmedo-Requena R, Luna-del-Castillo Jde D, Lardelli-Claret P. Contribution of exposure, risk of crash and fatality to explain age- and sex-related differences in traffic-related cyclist mortality rates. Accid Anal Prev 2015;76:152-8.  Back to cited text no. 31
    
32.
Kweon YJ, Kockelman KM. Overall injury risk to different drivers: Combining exposure, frequency, and severity models. Accid Anal Prev 2003;35:441-50.  Back to cited text no. 32
    
33.
Tenenbaum S, Weltsch D, Bariteau JT, Givon A, Peleg K, Thein R, et al. Orthopaedic injuries among electric bicycle users. Injury 2017;48:2140-4.  Back to cited text no. 33
    
34.
Hedjazi A, Attaran H, Hosseini M, Badiyan Mousavi N, Khademi A. Investigation of cycling deaths in Iran during 2010-2013. Iran J Forensic Med 2016;21:263-71.  Back to cited text no. 34
    
35.
Yavuz MS, Asirdizer M, Cetin G, Günay Balci Y, Altinkok M. The correlation between skull fractures and intracranial lesions due to traffic accidents. Am J Forensic Med Pathol 2003;24:339-45.  Back to cited text no. 35
    
36.
Bhandari M, Guyatt GH, Khera V, Kulkarni AV, Sprague S, Schemitsch EH. Operative management of lower extremity fractures in patients with head injuries. Clin Orthop Relat Res 2003;407:187-98.  Back to cited text no. 36
    
37.
Du W, Yang J, Powis B, Zheng X, Ozanne-Smith J, Bilston L, et al. Epidemiological profile of hospitalised injuries among electric bicycle riders admitted to a rural hospital in Suzhou: A cross-sectional study. Inj Prev 2014;20:128-33.  Back to cited text no. 37
    
Archives of Trauma Research
Volume 11, Issue 1
March 2022
Pages 26-31

Files

History

  • Receive Date: 18 June 2023
  • Accept Date: 18 June 2023

Share

How to cite

Statistics