@article{ref1,
title="Tram, rail, bicycle: an unhappy triad? Rising incidence and resource consumption of  tramline-associated bicycling accidents in Bern, Switzerland",
journal="Accident analysis and prevention",
year="2020",
author="Gerber, Joël L. and Suppiger, Tobias and Sauter, Thomas C. and Traschitzger, Michaela and Muller, Martin and Exadaktylos, Aristomenis K.",
volume="151",
number="",
pages="e105914-e105914",
abstract="Bicycle traffic and the number of accidents have been increasing in Switzerland in  recent years. However, little is known about specific types of bicycling accidents -  such as tramline-associated bicycling accidents (TABA) - that are potentially  avoidable. This retrospective single center study of emergency department (ED)  consultations analyzed TABA in the city of Bern, Switzerland. We analyzed the  medical records of adult patients who presented to the ED after any bicycle  accident. Patient and consultation characteristics were extracted. Incidence,  important characteristics and ED resource consumption of TABA were compared with  bicycle accidents that did not involve tramlines (BA). Furthermore, injury patterns  and predictors of resource consumption were determined in TABA. We included a total  of 298 TABA and 2351 BA over the 5.6-year study period. TABA accounted for 11.2 % of  all bicycling accidents. Descriptive analysis revealed a significant increase  between 2013 (lowest) and 2016 (highest) of 33.0 % in the total number of BA and 132  % in the total number of TABA. Compared to BA, TABA patients were significantly  older, more often female, had a less urgent triage, and less often needed  resuscitation bay treatment, hospitalization or ICU-admission (all p < 0.05). In  multivariable analysis, TABA were associated with greater needs for ED resources. Most TABA injuries were to limbs (70.5 %) or the head (53.0 %), including  intracranial hemorrhage (2.3 %). The radiological work-up consumed most of the  resources (37.5 %), followed by physicians' work (25.8 %). Statistically significant  predictors of ED resource consumption in TABA were age, triage, resuscitation bay  treatment, injuries to head/clavicle, and intoxication. One out of ten patients was  intoxicated. Although TABA is associated with less severe trauma than BA, it bears  the risk of significant morbidity and high ED resource needs. Intoxications  contribute to this problem. Our findings underline the need for preventive measures  to reduce TABA in the future.<p /> <p>Language: en</p>",
language="en",
issn="0001-4575",
doi="10.1016/j.aap.2020.105914",
url="http://dx.doi.org/10.1016/j.aap.2020.105914"
}