Scripties UMCG - Rijksuniversiteit Groningen
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Factors associated with injury severity in bicycle-related traffic accidents

(2017) Montes de Jesus, F.M.

Cycling is a common activity involving an increasing number of individuals all over the world. It is not only an environmentally friendly means of transportation, but also an excellent way of increasing physical-activity levels. Despite its benefits cyclists are at an increased risk of injuries as they are exposed to a whole array of hazards, especially when commuting with minimal or no protection. Cycling is embedded in the Dutch culture, characterized by some of the most avid bicycle users in the world. Consequently, bicycle-related traffic accidents have a great socioeconomic impact in the Dutch society. Therefore, the determination of factors that predict injury severity in bicycle-related traffic accidents is of primary importance to better organize prevention strategies. Because cycling accidents are multifactorial in its nature, one must encompass a wide range of variables when studying such a complex topic. Although previous literature has established potential influential factors, such as age, gender and bicycle type, culture and surrounding environment must be also taken into account. To our knowledge no study has yet assessed which factors are associated to injury severity of bicycle accident-related injuries specific to the Netherlands.
A cohort study was conducted, including patients above 18 years of age, seeking medical attention at the trauma center of the University Medical Center Groningen (UMCG) between July 2014 and December 2016. Data was collected through means of electronic patients files, the “Landelijke traumaregistratie” (LTR) and questionnaires. Considering the multifactorial nature of this study a multivariable logistic regression analysis was conducted, where Injury Severity Score (ISS) was the dependent variable. Primary outcome was potential effect predictors of multi-trauma (ISS>15) in bicycle-related traffic accidents.
During the research period 1010 patients were admitted to the trauma center, UMCG. From these patients 539 (53,4%) were male and 471 (46,6 %) were female. Patients presented with a broad spectrum of injuries. The most frequent injured body regions were the upper body (39.2%) and the head (31.2%). Effect predictors of multi-trauma due to a bicycle-related traffic accident were: age above 60 years old (OR=4.14), male gender (OR= 2.84), two-sided collision type of accident (OR=3.48), “other collision type” (OR=4.02) and collision type with an object had (OR=3.45).
We have identified potential variables associated with ISS>15 in bicycle traffic-related accidents specific to the Netherlands. Further data collection with the advised improvements is recommended as to provide means for a more accurate data analysis. Prevention strategies can then be established with the goal of maximizing benefits for the population

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