A52 Trends in inpatient admissions for pedal cycle injuries for the state of California: 2005-2011

Abstract

Abstract Background In the United States, cycling has grown substantially in popularity in recent years. It is unclear, however, whether pedal cycling safety, such as use of helmets, have kept pace with this rapid growth. We use administrative records of pedal cyclist crashes and hospitalizations to explore trends in injuries and fatalities among pedal cyclists in the state of California. Methods We perform a retrospective analysis of the Statewide Integrated Traffic Records System (SWITRS), the State Emergency Department Database (SEDD), and the State Inpatient Database (SID) for the state of California in 2005 to 2011. SWITRS contains all motor vehicle crash records reported to law enforcement in California and is maintained by the California Highway Patrol. SEDD/SID provide records on all emergency department (ED) and inpatient admissions in community hospitals for California. Pedal cyclist injury records were selected using Clinical Classification Software codes (External Causes of Injury code 2608 “Pedal Cyclist, not MVT”). We examine patient characteristics related to pedal cyclist injuries including age, gender, insurance status, race, disposition status and all related bodily injuries. Trends in number of bicycle-related injuries on public roads, and ED visits and inpatient admissions (number and per capita) are presented. Cost-to-charge ratios provided by HCUP are used to calculate costs of treatment for injured bicyclists. Results During the 7-year period from 2005 to 2011, there were 275,845 ED visits and 24,281 pedal cyclist-related inpatient admissions in the state of California. Number of ED visits per 100,000 population increased from 95.1 to 122.6 in 2005-11—a 29% increase. Much of this increase was driven by older pedal cyclists. The average age of a cyclist increased by 3.4 years in the study period, and the proportion aged 45 and older increased from 15.9% to 22.1%. For inpatient admissions, this proportion increased from 39.1% to 50.4%. Upper limb fractures and intracranial injuries were the most common types of injuries sustained by hospitalized pedal cyclists. Median inpatient costs of treatment were $11,264 per case, and totaled $59.7 million in 2011. Conclusions In an average week in California, there are about 26.5 million pedal cycling trips. Although pedal cycling is associated with a number of important cardiovascular and other health benefits, our study suggests that injuries have increased substantially as pedal cycling has become more popular. These results call for the need to examine pedal cycling safety efforts, especially among older riders who are at risk for serious injury.