Trends and Patterns in Bicycle Injuries: The Significance of Protective Equipment

Introduction This research presents a five-year comprehensive analysis of trends and efficacy related to helmet and protective equipment use in bicycle-related incidents. Our areas of comparison included injury severity, hospital stay, the Glasgow Coma Scale (GCS) scores, and demographic data. In light of the current increase in bicycle use popularity, this study aimed to provide clear information regarding the significance of protective equipment to combat the surge in bicycle-related incidents in recent years.  Methods A retrospective analysis was performed using the National Trauma Data Standard (NTDS) as a data source. Our inclusion criteria considered the mechanism of injury involving bicycle incidents, narrowing our pool of patients to 135,605. These cases were screened based on the following parameters: use of helmet/protective equipment, demographic criteria, and several other injury markers. Statistical analyses, including two sample t-tests, were performed using SAS.  Results A total of 5.7 million patients were screened for inclusion criteria, yielding 135,605 cases involving bicycle-related injuries between 2018 and 2022. Of the patients who met the inclusion criteria, patients wearing helmets had an overall high GCS score (p<0.001) and decreased hospital stay (p<0.001) compared to those without helmet use. Similar findings were drawn related to protective equipment use and GCS (p<0.001). The Injury Severity Score (ISS) on average was higher for those wearing helmets (p<0.001). Overall, an increase in helmet use was noted for the years in question (R²=0.467). Additional observations made include large variations in helmet use in different age groups. Patients aged <17 years wore helmets in just 6,514 (22%) cases while those aged +65 years wore helmets in 10,925 (51%) cases.  Conclusions This study observed a statistically significant difference between GCS values in helmet/non-helmet-wearing groups. Similar findings were found regarding other protective equipment use as well. A statistically significant difference was also found regarding increased ISS with helmet use. This challenges our current assumptions about improved injury severity with the use of protective equipment. In line with other studies, we determined that helmet use tends to decrease the level of injuries on the head. Overall, helmet use has increased in the past five years, but several demographic groups were found to wear protective equipment less often. We recommend future research that focuses on understanding the trends in protective equipment use among bicycle-riding individuals under the age of 25 years, Native Americans, and African Americans. Continued research regarding injury reduction interventions is of utmost importance, especially given the widespread increase in the popularity of bicycle use.