Bicycle-related injuries among preschool children

To describe the circumstances, severity, and outcome of bicycle-related injuries among hospitalized children younger than 5 years and to compare injuries in young children (< 5 years) and older children (5 to 14 years).

We studied a case series of children (0 to 14 years) with bicycle-related injuries requiring hospital admission reported to the National Pediatric Trauma Registry (NPTR) between January 1986 and June 1996.

Bicycle-related injuries were reported for 4,041 patients; 219 (5%) involved children younger than 5 years. Two young children and 124 older children (3%) wore bicycle helmets. Young children were less likely than older ones to be injured in the street (46% versus 81%, P < .001) and were more likely to be injured at home in the driveway or yard (39% versus 9%, P < .001). Interaction with a motor vehicle contributed to injuries in 31% of young children and 47% of older children (P < .001). Forty-five percent of young children and 56% of older children sustained head injuries (P < .002). The fractions of children in each age group with facial trauma, abdominal or thoracic injury, and fractures were similar. Pediatric Trauma Scores, Glasgow Coma Scale scores, operating room use rates, and median number of hospital days were similar for both age groups. Rehabilitation or extended care was required by 1% of young children and 2% of older children. Two deaths occurred among young children (1%); 2% of older children died.

Of patients with bicycle-related injuries reported to the NPTR, a minority are young children, but they have injuries similar in severity and outcome to those of older children. Because young children sustain severe injuries, including head trauma, helmets are indicated for them, as well as for older children.