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CHAPTER EIGHT: OUTCOME

8.1 PATIENT OUTCOME

This chapter explores the severity of injuries caused by cycling accidents. Staff at the five participating hospitals were asked to indicate the outcome of the accident in terms of whether the respondent was discharged without follow up, or whether they required follow up or admission to hospital.

A significant proportion (35%) of the forms were left blank at this question and not completed by hospital staff.

Table 19: Patient outcome

The majority of casualties of cycling accidents who presented at hospital were discharged on the same day and only 4% of casualties were admitted. If this is taken as a percentage of those that we do have data for this figure increases to 6%. The statistics in the following commentary and tables are calculated on the basis of the sample for whom data is available.

There were only slight differences in outcome between males and females. A slightly higher proportion of male casualties were admitted than females (7% compared to 5%) whilst more females than males were followed up after discharge (42% compared to 31%). However, a greater proportion of males were discharged without a follow up than females (53% compared to 48%).

Children were more likely to be admitted than adults (8% compared to 4%). It is not known whether their injuries were more serious since more precautions may be taken with children than adults.

Table 20: Patient outcome by other vehicle involved

Base = those for whom outcome data is available i.e 521

An examination of outcome by whether another vehicle was involved reveals that none of those for whom a car / bus or commercial vehicle was involved were admitted to hospital. This compares with 17% admitted for those who were involved with another cyclist. The majority of those involved with a motorised vehicle were discharged with no further follow up (65%) and a quarter were asked to return for some kind of follow up with a further 10% referred to another department.

There was little significant difference in outcome depending on whether the accident took place on or off road. Fifty-five per cent of those whose accident was on the road and for whom we have data were discharged without a need for follow up compared to 48% of the off road casualties.

8.2 INJURIES SUSTAINED

Figure 10 examines in what respect the cyclist was injured.

Figure 10: Body part injured

Note: multiple coding was possible as each casualty could have more than one part injured

The most common injuries were to upper limbs accounting for 38% of all of the casualties presenting to hospital, followed by injuries to lower limbs (20%) Injuries to the head and neck accounted for some 11% of all casualties and injuries to the face accounted for 15%.

Figure 11: Body part injured by location of accident

Head and neck injuries were least common amongst the off road casualties (8%) and most common amongst those casualties whose accidents occurred on the pavement (15%).

Injuries to the upper limbs were the most common no matter where the accident took place. They were however most common amongst on road casualties (41%) and least common amongst those whose accident took place on the pavement (35%) and this is likely to correlate with the age of casualties more prevalent in these locations.

Table 21: Body part injured by adult / child

Children are slightly more likely to sustain injuries to their heads or necks than adults (12% compared to 9%) and this is consistent with the greater proportion of this type of injury sustained on pavements. Adults by contrast are much more likely than children to damage their lower limbs (27% compared to 15%).

Injuries to the upper limbs, which were the most common injury overall, were only slightly less common amongst children than adults (37% compared to 40%).

8.3 EFFECT OF WEARING A HELMET ON INJURIES SUSTAINED

Whilst wearing a helmet did not seem to affect the proportions who were more seriously injured, as measured by whether they required hospital admission or follow up, they did have an effect on the site of the injury.

Those who were wearing a helmet at the time of their accident were much less likely to have an injury to their head or neck (7% compared to 14%). Those wearing a helmet were more likely to injure their upper limbs (46% compared to 35%) or their lower limbs (25% compared to 17%).

Table 22: Body part injured by whether helmet worn

Other than differences to injuries to lower limbs already reported as being more prevalent in adults, there was little difference between adults and children with regard to site of injury by whether or not a helmet was worn. The difference in the extent of head and neck injuries by helmet wearing is more pronounced amongst children ( 8% compared to 14%) than for adults (7% compared to 11%).

Table 23: Part of body injured in accident by whether helmet worn by child / adult

Of those who did have a head or neck injury, 27% were wearing a helmet, a lower proportion than the 39% across the entire sample who were wearing one at the time of their accident.

8.4 TYPE OF TRAUMA

The following table provides further information about the type of trauma sustained by pedal cyclists by the site of the injury.

Table 24: Type of trauma

The most common trauma to be sustained was an abrasion. This was particularly common with face injuries.

Of those who had an injury to the upper limbs, 36% were a simple fracture. This was less common in the lower limbs which were much more likely to have abrasions, cuts and bruising.

Summary of key findings

• Data was not provided on outcome for 35% of the sample.
• The greatest proportion (34%) of casualties were discharged on the same day without any need for follow up.
• Only 4% of casualties were admitted.
• Just over one in five casualties ( 22%) required follow up treatment.
• Children were more likely to be admitted than adults.
• Wearing a cycle helmet made little difference to the outcome in terms of their need for admission or follow up treatment.
• The most common injuries were to upper limbs (38%) followed by lower limbs (20%).
• Injuries to the head or neck were sustained by 11% of total casualties.
• Children were only slightly more likely to sustain injury to their head or neck than adults (12% compared to 9%).
• Those who were wearing a helmet at the time of their accident were less likely to have an injury to their head or neck (7% compared to 14%)
• The most common trauma to be sustained was an abrasion (41%) followed by laceration (35%). Simple fractures were common amongst those who had injured their upper limbs (36%).

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