Bicycle-Related Trauma Trends in a Region of Expanding Cycling Infrastructure

Abstract

Background

Cycling has become increasingly popular nationwide, with our region showing a particularly sharp rise. In 2022, 31.6% of residents reported cycling at least 12 days in the past year, compared to 21% nationally. Trail use in the region rose by 36% from 2015 to 2019. As the area’s only level II trauma center, we hypothesized a parallel increase in cycling-related trauma admissions.

Methods

We conducted a retrospective cohort study using our institutional trauma registry to identify bicycle-related hospitalizations from 2014 to 2022. Annual trends in injury incidence, demographics, severity, and hospital length of stay were analyzed and compared with existing regional trail usage data (2015-2019) and crash reports from the State Police (2015-2021). Descriptive statistics and unadjusted analyses were performed.

Results

A total of 191 patients were hospitalized for bicycle-related trauma (1.9% of all trauma admissions); over 41% required intensive care unit/operating room admission. The mean Injury Severity Score was 11.9 (SD = 8.3), and head trauma was the most common injury (mean head abbreviated injury scale 2.6; SD = 1.1). The cohort was 82% male, with a mean age of 44.8 (SD = 18.0) years. No significant annual increase in bicycle-related hospitalizations, injury severity, or reported crashes from police data was observed despite greatly increased bicycle usage.

Conclusion

Despite rising cycling activity, bicycle-related hospitalizations and crashes did not increase. This may reflect the protective impact of expanded cycling infrastructure. As most severe or fatal bicycle injuries occur on urban roadways, the regional emphasis on dedicated cycling infrastructure may play a protective role in reducing trauma incidence.