Injury Incidence and Predictors on a Multiday Recreational Bicycle Tour: The Register's Annual Great Bike Ride Across Iowa, 2004 to 2008

摘要

Objective.—The “Register’s Annual Great Bike Ride Across Iowa” (RAGBRAI) is a 7-day recreationalnbicycle ride with more than 10,000 participants covering 500 miles. The heat and humidity of late July innIowa, the prevalence of amateur riders, and the consumption of alcohol can combine creating the potentialnfor a significant number of injuries. The purpose of this study is to determine the type, quantity, and severitynof injuries on RAGBRAI and gather data on the factors related to these incidents.nMethods.—This retrospective chart review examined ambulance “run sheets” for patients requiringntransport to the hospital from the bike route between 2004 and 2008. These run sheets included name,nage, chief complaint, anatomic location of injuries, medications administered, procedures performed,nand a full narrative describing the initial scene, patient’s account of the incident, services provided, andnongoing condition of the patient while en route to the hospital. Chi-square tests, Pearson’s correlationntests, and t tests were applied to determine significant statistical outcomes.nResults.—From 2004 to 2008, Care Ambulance Inc provided on-route medical services for 419nRAGBRAI participants. Of these participants, 190 (45.3%) required transport to a local hospital bynCare Ambulance Inc. Females were more likely to require transport, as they comprised 46.3% ofntransported patients while only representing 35% of all RAGBRAI participants (P u0001 .001). For men,nincreasing age was a significant predictor of transport, particularly males between the ages of 60 andn69 years old (P u0001 .01). Of the 148 run sheets where mechanism of incident was documented, 114nincidents were caused by rider factors (77.0%), 29 by road factors (19.6%), and 5 by bicycle factorsn(3.4%). Higher heat indexes were correlated with an increased number of dehydration cases (r u0001 0.979,nP u0001 .02). Of participants who reported with minor injuries to a mobile first aid station and did notnrequire transport, 90.1% had not imbibed any alcohol. Bony injuries were more common above thenwaistline as 39/45 (86.7%) fractures occurred to the clavicle, shoulder/proximal humerus, hand, ornhead. The most common bony injury each year of RAGBRAI was a clavicle fracture, which representedn44.4% of all recorded fractures from 2004 to 2008. Lacerations and abrasions were also more commonnabove the waist, as 63.5% (127/200) of soft tissue injuries requiring treatment were either to the headnor upper extremities. No specific event day showed any correlation with increased injury (P u0002.05).nConclusions.—This study suggests that females and older males are more likely to require transport forninjuries sustained on RAGBRAI, the majority of injuries occur around the head and upper extremities,ndehydration case load is correlated with heat index, and that incidents are usually caused by rider factors.nThis research could be used by multiday recreational bicycle tour organizers to continue educating riders onnriding carelessness and etiquette and prepare medical services for certain quantities and types of injuries.