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Patterns Of Bicycle Rider Injury Defined By Latent Class Analysis
*JOSEPH PIATT
A I DUPONT HOSPITAL FOR CHILDREN, WILMINGTON, DE

Background (issue):
Bicycle ridership is a notable source of pediatric trauma. Previous study has examined injuries to single organ systems, such as the brain or the abdominal viscera, or has considered bicycle trauma as an undifferentiated, homogenous entity. The current exploratory study uses a method novel to trauma research, latent class analysis, to identify patterns of injury and to study their associations.
Methods:
Cases of injury while riding a bicycle among patients 0 through 18 years of age were identified by ecodes in the 2017 data of the Trauma Quality Improvement Program of the American College of Surgeons. Injuries to major organ systems were identified by Abbreviated Injury Scale predot codes. Latent classes were developed on the basis of organ system injuries, total numbers of injuries, and Injury Severity Scale scores.
Findings:
There were 6151 injured bicycle riders. A model with 7 classes had excellent fit and interpretability. The classes were characterized as follows: severe polytrauma (2.0%); abdominal visceral injury (9.6%); isolated head injury (5.6%); isolated upper limb injury (21.9%); isolated lower limb injury (13.4%); many minor injuries (7.3%); and few minor injuries (40.2%). These classes had highly significant associations with mortality, length of stay, helmet wear, injury in traffic, race and ethnicity, sex, and age. Injury class retained a highly significant association with helmet wear in multivariate analysis.
Conclusions (implications for practice):
Patterns identified by latent class analysis may have important implications for bicycle injury prevention and management.


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