Incidence and severity of electric scooter related injuries after introduction of an urban rental programme in Vienna: a retrospective multicentre study

Understanding e-scooter rider crash severity using a built environment typology: A two-stage clustering and random parameter model analysis

E-scooters are an emerging transport mode that is transforming urban mobility; however, their proliferation has raised concerns about safety. This study combines UK e-scooter crash data with built environment characteristics from the crash locations. A two-stage framework was followed: first, a typology of built environments was developed using K-means++; second, crash severity within each cluster was analysed using a random parameter binary logit model. Four built environment clusters were identified: (1) car-centric and mixed-use zones, (2) commercial and industrial zones, (3) intersection-dense areas, and (4) residential and central areas. Collisions with motor vehicles, younger e-scooter riders, and higher speed limits were the most common risk factors across the clusters, with the first two clusters showing a higher impact of these factors on the likelihood of severe crashes. In the first and second clusters, riding on the carriageway significantly increased injury severity. In the second cluster, three collision types were significant, more than in other clusters where only side-impact collisions were significant. This indicates high e-scooter-motor vehicle friction in the second cluster. Among all collision types, head-on collisions increased the likelihood of severe outcomes more than others. In the third and fourth clusters, peak hours were associated with a lower likelihood of severe crashes, while this variable showed the opposite impact in the first cluster. The results highlight that consideration of the surrounding built environment is paramount when analysing e-scooter crash severity, as unique contributing factors were identified specific to each built environment type, along with varying magnitudes or directions of marginal effects.

Scooter accidents in the megacity of Istanbul: An analysis of orthopedic injury trends and characteristics from a level I trauma center

AIM

This study aimed to analyze orthopedic injury patterns and characteristics resulting from scooter accidents in Istanbul, Turkey, focusing on trends related to time, day, season, and demographic factors.

METHODS

We conducted a retrospective analysis of 375 patients treated for scooter-related injuries at a Level I trauma center in Istanbul. The study period spanned the years of 2018 to 2023. Injuries were categorized by body region and treatment types were analyzed, including the need for surgical intervention and associated costs. Seasonal and temporal patterns of injuries were examined with specific attention to peak admission times and days of the week.

RESULTS

The study population consisted of 250 male (66.7%) and 125 female patients (33.3%), with a mean age of 22.6years. Most injuries were due to low-energy trauma (86.4%), with only 13.6% resulting from high-energy trauma. The majority of patients had upper extremity injuries (45.1%), followed by lower extremity injuries (26.9%). Fractures were present in 57% of cases with common injuries including hand-wrist fractures (17.1%) and elbow fractures (13.9%). Surgical intervention was required for 10.9% of these patients and the remainder were treated conservatively. The mean cost for patients with fractures was significantly higher for those requiring surgical treatment ($602.28) compared to conservative management ($36.49, p=0.001). A peak in admissions was identified at 8:00PM, with significant injury rates observed on Mondays, Thursdays, Saturdays, and Sundays. Increased admissions were observed from May to September, with July being the busiest month. From 2018 to 2021; there was a 250-350% increase in scooter injuries, followed by a decrease in 2022 and 2023.

CONCLUSION

Our study reveals a notable trend of increased scooter-related orthopedic injuries in Istanbul, particularly during late afternoon and evening hours and on weekends. The seasonal peak in injuries supports the association between warmer weather and higher scooter use on holidays and days off. The observed increase in injuries followed by a more recent decline may reflect changes in mobility patterns due to the COVID-19 pandemic. These results highlight the need for targeted preventive measures and safety interventions during peak times and seasons to reduce scooter-related injuries in urban settings.

Electric scooter injury and trauma in Edmonton: a multicentre prospective and retrospective observational study

BACKGROUND

The introduction of rentable electric scooters (e-scooters) has been associated with injury presentations to emergency departments (EDs). Our objective was to determine the incidence and severity of injuries from rentable e-scooters among adults presenting to EDs in a northern urban region.

METHODS

Adults presenting to all Edmonton EDs with injuries related to rentable e-scooters during 3 summers (2019-2021) were eligible for inclusion. We identified e-scooter charts using multiple sources: administrative data, trauma registry, and text-based triage searching. Two independent reviewers assessed each patient for study inclusion; disagreements were resolved by content experts. Trained researchers performed data extraction and descriptive statistical analysis.

RESULTS

We included 759 e-scooter-related injury presentations. The median age was 28 years, males and females were almost equally represented, 20% presented by ambulance, and 14% were triaged as urgent. Most patients had multiple injuries (62%), with fractures (32%) and head injuries (17%) being common. Helmet use was infrequent (2%) and concurrent substance use was prevalent (26%). Admission to hospital was uncommon (5.5%); however, 30% of patients presenting to an ED with an e-scooter injury required further follow-up, with 9% undergoing surgery within 30 days of their index visit.

CONCLUSION

Injuries related to rentable e-scooters are increasingly common. Most injured patients have multiple injuries and require investigations, and a third require further management. These injuries represent substantial burdens to patients and the health care system in Canada. Injury prevention strategies should be considered to reduce injuries.

Orthopedic Injuries Caused by Electric Scooters: A Systematic Review

Background

Orthopedic-related injuries are a significant proportion of electric scooter (e-scooter) injuries that present to hospitals. There is a lack of global regulatory consensus for e-scooter use.

Aims

We aimed to synthesize existing data on orthopedic injuries due to e-scooters and identify modifiable risk factors that will help guide policymaking, reduce hospital burden, and aid clinicians in the management of these injuries.

Methods

A systematic review of the literature was conducted to identify studies pertaining to e-scooter injuries. The U.S. National Library of Medicine (PubMed/MEDLINE), EMBASE, and the Cochrane Database of Systematic Reviews were queried for publications from January 1980 to November 2022, utilizing keywords pertinent to electric scooter, orthopedic or musculoskeletal injuries, incidence, and prevalence.

Results

In total, 30 studies met inclusion criteria. Among all riders, 5.5% were helmeted. Among those injured, 26.3% were intoxicated at the time of injury, 7.6% required inpatient admission, and 20.5% required surgery. The most common orthopedic injuries were to the distal extremities, with wrist fractures being the most reported upper extremity fractures (average 14.9%) and ankle fractures being the most reported lower extremity fractures (average 8.3%).

Conclusions

Orthopedic injuries caused by using e-scooters are commonly encountered in the hospital setting. These injuries may continue to rise with the increased accessibility of e-scooters. Lawmakers should instill strict usage guidelines to help prevent injuries from e-scooter use.

Continuously increasing e-scooter accidents and their possible prevention in a large European city

PURPOSE

During the last few years, the number of electric scooter (e-scooter) users has risen to an all-time high. This study aimed to analyze e-scooter related accidents and trauma prevention measures in a large European city (Vienna, Austria).

METHODS

This retrospective study comprises a thorough data assessment and analysis of all e-scooter related accidents between 2018 and 2021 at a large level 1 trauma center in Vienna. Based on the data analysis, risk factors were identified, and possible prevention strategies were proposed.

RESULTS

During the observed period, 1337 patients sustained an injury from an e-scooter. Of these, 1230 were injured directly while driving (92%). The remaining 107 patients (8%) were classified as non-driving injuries. 927 injuries involved males (69.3%). The mean age was 32.1 years (range 4-86 years). Of all injured patients, 429 (32.1%) sustained at least one serious injury. The most common injuries included radial head fractures and concussions. Among the accidents treated, the use of protective equipment was sporadic. For example, helmets were worn in only 13.7% of cases. Wearing a helmet reduced the number of head injuries (24% versus 46.8%). In just three years, the number of patients increased 19-fold with a focus in the summer months.

CONCLUSION

This study shows a substantial and sustained increase in e-scooter accidents with potentially serious injuries. Helmet use was found to be an effective form of head injury prevention. Further options for using protective equipment should be evaluated to improve the safety aspects of riding e-scooters.

Kinematic characterization of micro-mobility vehicles during evasive maneuvers

INTRODUCTION

Over the last decade, the increasing popularity of Micromobility Vehicles (MMVs) has led to profound changes in personal mobility, raising concerns about road safety and public health. Therefore, the effective characterization of their kinematic performances and safety boundaries is becoming crucial. Hence, this study aims to: (1) characterize the MMVs kinematic behaviors during emergency maneuvers; (2) examine how various power sources affect their performances; and (3) assess the suitability of a piecewise linear model for modeling their trajectories.

METHOD

We conducted a test track experiment involving 40 frequent riders performing emergency braking and swerving maneuvers on different electric MMVs, their traditional counterparts, and behaving as running pedestrians. A second experiment determined the swerving boundaries of different devices estimating their minimum radius of curvature.

RESULTS

Electric MMVs displayed superior braking capabilities compared to their traditional counterparts, while the opposite was observed in terms of swerving performances. Performances significantly varied across MMV-types, with handlebar-based devices (bicycles and scooters) consistently outperforming the handlebar-less MMVs (skateboards and onewheel). The piecewise linear models used for braking profiles well fitted most MMV trajectories, except for skateboards and pedestrians due their foot-ground interaction.

CONCLUSIONS

This research highlights the influence of MMVs-specific characteristics on their maneuverability, underscoring that steering or braking effectiveness in collisions may vary depending on device type and power source. Piecewise linear models effectively generated parameterized functions for modeling braking trajectories, despite further improvements are suggested given the inapplicability of the single brake-ramp assumption to all the MMVs.

PRACTICAL APPLICATIONS

The identified similarities and distinctions between MMVs could offer insights to traffic regulators and may assist MMV designers and manufacturers in enhancing the devices users' safety. The piecewise model results allow traffic events reconstructions and simulations, enabling intelligent driving system to predict MMV riders' evasive actions in critical situations.

Patterns of orthopedic injuries associated with increasing e-scooter-related trauma: A retrospective observational study with a 4-year evaluation from a tertiary center in Istanbul, Turkey

The increasing use of electric scooters (e-scooters) has been accompanied by an increase in the number of traumas. Noncompliance with regulations and the effectiveness of legal measures remain subjects of ongoing debate. This study aimed to investigate the demographic characteristics of patients with e-scooter-related orthopedic injuries, temporal distribution of trauma, and patterns of these injuries. We retrospectively evaluated 534 patients with e-scooter-related injuries who were referred to the Department of Orthopedics and Traumatology between January 2020 and October 2023. Variables such as patient sex, age, time of trauma, type of hospital transfer, mechanism of trauma, injury location and type, accompanying head trauma in extremity injuries, and treatment approach were recorded. Temporal analysis was performed by hour, day, month, season, and weekday versus weekend. The majority of patients were male (80.0%), with injuries most common in the 25 to 39 age group (33.7%). Trauma was frequent in the summer (45.7%), especially in July (16.5%), with most hospital visits occurring on Fridays (18.2%) and weekends (32.2%). Blunt soft tissue injuries (47.3%) and fractures (42.4%) were prevalent, particularly in the elbow (18.4%), wrist (16.9%), and knees (14.3%). A total of 247 fractures were identified, with the radial head (17.0%) and distal radius (10.9%) being the most common fractures. Fracture rates have increased in 2022 and 2023 compared to those in previous years. While 86.0% of patients received nonsurgical treatment, 14.0% underwent surgery, with a rise in surgical cases in 2022 and 2023. Elbow (19.0%), knee (16.7%), and wrist (16.7%) were the most frequent surgical sites. The increasing use of e-scooters among young people has increased trauma cases, with a growing proportion of fractures over time. The higher incidence of injuries, particularly in the elbow and knee joints, underscores the importance of protective equipment. Therefore, additional legal regulations can help to prevent such injuries.

Assessing head injury risks in electric scooter accidents: A multi-body simulation study with insights into sex differences

E-scooters have become increasingly popular for short-distance travel in urban areas, but this rise in usage also brings about an increased risk of accidents. Studies have shown that approximately 40% of electric scooter accident victims admitted to hospitals suffer head injuries. Therefore, it is crucial to implement safety measures and improve safety systems and equipment to mitigate these risks. One approach to gaining insights into the injuries users face is through simulations using the multi-body method. This method allows for the reconstruction of accidents by modeling and analyzing the dynamic behavior of interconnected bodies. This study aims to assess the impacts on the user's head and the injuries they may sustain in electric scooter accidents using numerical methods. Initially, a reference scenario was established based on a YouTube video, with the assumption that the user was an average-height man. Simulations were conducted for various percentiles, including both males and females. Different velocities were simulated to determine the threshold velocity at which survival becomes practically impossible. Two scenarios were considered: one where the car braked for 0.333 s and another where the distance between the start the braking task and the collision was kept constant. The location of the first head impact on the vehicle was also examined. Injury assessment was conducted using two criteria: Head Injury Criterion (HIC) and Brain Injury Criterion (BrIC). The study found that smaller individuals are more vulnerable to severe injuries, and higher car velocities correlate with more severe user injuries. Furthermore, the location of the first impact varies between genders, with women more likely to experience impacts in the lower part of the windshield, while men tend to experience impacts in the central zone. This study highlights the importance of considering user characteristics and accident dynamics in assessing injury risks associated with e-scooters.

Paediatric e-scooter riders at high risk of life-threatening traffic accidents

BACKGROUND

This study presents the epidemiology and the development of e-scooter and non-electric scooter injuries in children and adolescents to highlight the nature and the severity of such injuries.

METHODS

All children and adolescents with electric or non-electric scooter related injuries between January 2019 until December 2022 were included in this single-centre study and retrospectively evaluated. An epidemiological overview including age, sex, type of scooter, injury mechanism, diagnosed injuries and surgical interventions were presented. Further, statistical comparisons of the means and proportions of injuries and the number of surgical interventions between electric and non-electric scooter riders were made.

RESULTS

The study consists of 633 children and adolescents (9.1 ± 5.0 years; 231 female, 36.5%, 402 male, 63.5%). 80.1% (8.0 ± 4.1 years) used non-electric scooters, while 19.9% (14.2 ± 4.1 years) used e-scooters. In comparison, adolescent e-scooter riders were significantly more likely to be involved in traffic accidents (non-electric scooter: 16/507; e-scooter: 21/126; p = 0.0001) and suffered severe head injuries more often (non-electric scooter: 8/134; e-scooter: 7/37; p = 0.0217) than patients riding non-electric scooters.

CONCLUSION

Adolescent e-scooter riders were more likely to be involved in potentially life-threatening traffic accidents having a higher risk of severe head injuries requiring surgery compared to non-electric scooter riders.

IMPACT

Adolescent e-scooter riders have a higher risk to be involved in potentially life-threatening traffic accidents than riders of non-electric scooters. E-scooter riders have a higher risk of sustaining serious head injuries requiring surgical intervention than non-electric scooter riders. The data highly recommends the implementation of prevention strategies especially educating youth and parents and wearing protective clothing. Legislation and law enforcement could help prevent such injuries and potentially life-threatening traffic accidents involving children and adolescents who ride e-scooters.

Head, face and neck injury patterns for electric scooter accidents identified on computed tomography scanning: Does legislative change enforcing safer riding practices have an impact on morbidity for significant head, face and neck trauma?

INTRODUCTION

The purpose of this study is to review whether legislative change enforcing safer riding conditions for Electric Scooters (E-Scooter), regardless of other factors, had an impact on reducing significant head, facial and neck trauma. Additionally, to identify the radiological injury patterns for head, face and neck injuries identified on CT imaging for a patient's initial presentation to the emergency department (ED) resulting from an E-Scooter accident.

METHODS

A retrospective single-centre observational study at a metropolitan tertiary ED of patients presenting after an E-Scooter accident comparing 6 months before and after legislative change.

RESULTS

Four hundred and forty-three patients presented following an E-Scooter accident: 191 patients 6 months before and 252 patients 6 months after legislative change. One hundred and sixty-two patients pre- and 217 patients post-legislative change had negative CT studies. Twenty-nine patients pre- and 35 patients post-legislative change had CT studies demonstrating significant head, face or neck trauma. The most common type of intracranial bleeding was subarachnoid haemorrhage followed by subdural haemorrhage with a significant proportion (41%) presenting with multi-factorial intracranial bleeding. There was no specific injury pattern involving the cranial vault or cervical spine. Of the patients presenting with a significant injury, facial bones were the most common injury site (84% (n = 54)). The most common site of facial fractures was the nasal bones followed by dental trauma and maxillary fractures.

CONCLUSION

This single-centre, retrospective observational study has shown no reduction in serious head, neck and facial injuries. Large-scale, multicentre studies will need to be undertaken to understand the true impact of legislative change.

Electric scooter - related CT - positive brain injuries: a five - year single - centre experience overview

The popularity of electric scooters (ES) during the last five years due to climate neutrality and public availability led to increased numbers in traffic accidents with significant injuries. This study was conducted to overview e-scooter related computed tomography (CT) positive traumatic brain injuries, exploring circumstances, clinical course, outcomes and possible relations to behavioral patterns. We retrospectively reviewed medical data of all patients treated in our center during the period 2019 to 2023, medical records were analysed and statistically processed. This review included 45 patients, 75.7% were males and median age was 40 years old. Patient numbers did not differ between weekdays, working days versus weekends and time of the day. Eighty percent of patients were injured from falling off the scooter, the rest were hit by another vehicle while riding. None of the patients were known using helmet, significant alcohol intoxication was found in 68.8% of cases. The most common traumatic intracranial features were subarachnoid hemorrhage (55.6%), followed by brain contusions (48.9%), epidural (26.7%), subdural (26.7%) hemorrhages. Age had a positive correlation with alcohol intoxication (r = 0.596, p = 0.007) and poor outcomes (r = 0.522, p = 0.004), also, men over 40 years old were more likely to undergo surgery (p = 0.024), meanwhile operated patients suffered more infections (p = 0.011) and more often ended with poor outcomes (p < 0.001).

Electric Scooter Falls: The 2023-2024 Experience in the Clinical Emergency Children's Hospital in Galați

(1) Introduction: Since electric scooters were launched in 2017, they have become increasingly popular worldwide and a cause of childhood trauma. (2) Case reports: This paper has a double-fold purpose: it reports two cases of epidural hematomas and compares them with electric scooter-related head trauma in the literature. An overview of the literature on this topic was performed to make such a comparison. Our cases are one of almost 52 cm3 and one of 129 cm3, both in two eight-year-olds. (3) Discussion: Although usually mild, traumatic brain injuries following e-scooter falls can also be moderate and severe. Reduced helmet use, high speed, and a lack of experience are the perfect set-up for potential severe injuries. Intracranial bleeds are not frequent, and epidural hematomas are rare in such cases, but they can significantly impact the individual, community, and healthcare system. No other medium- or large-sized epidural hematomas were reported in children sustaining electric scooter-related head trauma. (4) Conclusions: Our review parallels the literature and our hospital's experience. Although there are both similarities and discrepancies between our cases and the literature, mild trauma should not be disregarded, for it may hide serious complications requiring immediate surgery.

[Electric scooter-associated orthopedic injuries cause long absence from work, regret and are emerging as a major cause of hip fractures in young individuals: a comprehensive study from a regional trauma center in a densely populated urban setting]

PURPOSE

This study aimed to give a full spectrum of orthopedic injuries associated with electric scooter (e-scooter) use and analyze related factors, report on follow-up data from the patient's perspective and make a comparative etiological analysis of young adult hip fractures.

METHODS

A total of 851 consecutive patients were admitted to the Emergency Department following e‑scooter injuries between January 2021 and July 2022, of whom 188 had 214 orthopedic injuries. The demographics, injury, and incident characteristics of these patients were collected. All fractures were classified as per the AO/OTA classification. Two groups were created as operatively or conservatively treated patients and data were comparatively analyzed. Follow-up examination incorporated a survey using binary questions on patients' perspectives. An etiological comparative analysis of hip fractures in young adults admitted to the same center between 2016 and 2022 was conducted.

RESULTS

The median patient age was 25. Inexperienced drivers constituted 32% of the injured. The protective gear use rate was at 3%. Higher speed (p = 0.014) and age (p = 0.011) were significantly associated with operative treatment. A total of 39% of the operated patients could not return to preinjury physical function, while 74% regretted using an e‑scooter. The most common etiological factor for traumatic young hip fractures was fall from a height between 2016 and 2020, whereas it became e‑scooter accidents in 2021-2022.

CONCLUSION

The rate of e‑scooter-related operative treatment is high and leaves the patient in regret (84%) and a physically limited condition (39%). A speed limit of ≤ 15 km/h could decrease the rate of operative injuries. The e‑scooter was identified as the top etiological factor in the last 2 years for traumatic young hip fractures.

LEVEL OF EVIDENCE

II, Diagnostic cohort study.

Work-related road traffic accidents: emergence of new modes of personal journey - analysis based on data from a register of road traffic accidents in France

INTRODUCTION

According to the 2018-2019 People Mobility Survey, work-related journeys (commuting and on-duty journeys) account for approximately 25% of all journeys. The use of non-motorised (nm) and motorised (m) personal mobility devices (PMDs) has steadily increased since their introduction into the French market in the last decade.

OBJECTIVE

This study aimed to describe the characteristics of work-related road accidents and their evolution since the introduction of new PMDs in France and the increase in the use of scooters.

MATERIALS AND METHODS

This was a retrospective, cross-sectional study using data from the Rhône Road Trauma Registry. Data were collected from 2015 to 2020. We included the data for the victims aged 18-70 years who were injured in work-related road accidents.

RESULTS

We identified 11 296 individuals aged 18-70 years who experienced work-related road accidents. An injury report was provided for a total of 11 277 patients. A total of 546 passengers and 78 drivers of other motorised vehicles (buses/trams, construction equipment and tractors) were excluded from the analysis. Seven patients died at the time of the accident and seven died after hospitalisation. Of the 10 653 (94.4%) victims, there were pedestrians (5.1%) or riders of bicycles (16.9%), scooters (3.8%), other PMDs (roller blades, skateboards, monowheels, gyropods and hoverboards; 0.4%) and motorised two wheelers (21.4%), or drivers of car (45.3%), and truck (1.5%). More than half of the scooter riders and 80% of other PMD riders were men. More than 60% of other PMD riders and 53% of scooter riders were under 34 years of age. Most scooter road accidents occurred during commuting (95.6%). 65% of the scooter accidents and 50% of other PMD accidents did not have opponents. Overall, one-quarter of the victims experienced accidents without opponents. Most scooter riders had injuries to their upper limbs (59.2%), lower limbs (46.8%), face (21.2%) or head (17.9%).

DISCUSSION

This original study on work-related road accidents allowed us to characterise the increase in work-related road accidents associated with new modes of travel, particularly scooters. The results observed for users of scooters and other PMDs in this study were generally consistent with those found in the scientific literature. Despite limited data, the results suggest that accidents involving scooters or other PMDs are of low severity.

CONCLUSION

Many head injuries could be prevented with more widespread use of helmets, among scooter and other PMD users and bicycle users.

The characteristics of e-scooter accidents reported by police in Türkiye

OBJECTIVES

Shared e-scooter service has been offered by various operators in Türkiye since 2019. The use of private and shared e-scooters is increasing, especially in large cities. This raises social concerns about the dangers e-scooters pose regarding traffic safety and injuries requiring medical attention. This study aims to investigate the accidents related to e-scooters in Türkiye to determine the contributing factors and accident characteristics.

METHODS

In this study, accident reports (collision reports) for 780 e-scooter collisions that occurred in 2021 in Türkiye were examined, and 771 accidents were included. Accident data were obtained from the Traffic Department of the Ministry of Interior, General Directorate of Security. Descriptive statistics of the factors affecting e-scooter accidents are presented to determine the relationship and differences; chi-square tests, independent samples t-tests, one-way analysis of variance, and binary logistic regression methods were used.

RESULTS

Male e-scooter riders are involved in crashes and injured approximately 4 times more often than female riders. The average age for men injured in e-scooter accidents is 30.4, and the mean age for women is 27.2. For both males and females, most injuries occurred in the 15 to 20 age group. Riders under the age of 18 constitute a significant proportion of the accidents (32.5%). Most e-scooter accidents occur on Mondays and during the month of August. Most accidents occurred between 12:00 p.m. and 1:59 p.m. (15.7%) and between 4:00 p.m. and 5:59 p.m. (15.7%), mainly during the daytime. About half of the accidents occurred at intersections. In 10.5% of accidents, the accident occurred at a pedestrian crossing. Approximately one-fifth of the accidents involved falls, and the most common type of collision was a side collision (44.2%). The binary logistic regression model showed that multivehicle accidents occur more often at intersections and during busy traffic hours. Single-vehicle accidents are more common on concrete roads and stone block roads.

CONCLUSIONS

Deaths and injuries caused by road traffic accidents are a public health problem in Türkiye and constitute a significant health burden. If necessary precautions are not taken, this burden is likely to increase. We hope that the findings from this study will help reduce e-scooter accidents in Türkiye.

Secular trends in the incidence and severity of injuries sustained by riders of electric bikes and powered scooters: The experience of a level 1 adult trauma center

BACKGROUND

The incidence of injuries caused by electric bicycles (E-bikes) and powered scooters (P-scooters) continues to increase. Data on the severity of those injuries is conflicting. The purpose of this study was to explore secular trends in the incidence and severity characteristics of patients following E-bike and P-scooter injuries and predictors for major trauma.

METHODS

A retrospective cohort study of patients aged ≥16 years following E-bike and P-scooter injuries was performed at a level 1-trauma center between 2017 and 2022. We explored secular trends in major trauma cases (primary outcome), emergency department (ED) visits, hospitalizations, and surgical interventions (secondary outcomes). Major trauma was defined by either an injury severity score (ISS) >15 or the patient's need for acute care, defined by any of the following: Intensive care unit admission, direct disposition to the operating room, acute interventions performed in the trauma room, and in-hospital death. Primary and secondary outcomes were compared between two time frames (2017-2018 vs.2019-2022).

RESULTS

In total, 9748 patients were presented following P-scooter and E-bike injuries. Of them, 1183 patients (12.1%) were hospitalized (854 males [72.2%],median age 33 years, median ISS 9).During the study period, the number of ED visits increased by 21-fold, with a parallel increase hospitalizations and surgical interventions numbers, which increased by 3.4-and 3.8-fold, respectively. Numbers of patients with ISSs >15 and patients who required acute care sharply increased during the study period, but no significant differences were found in the percentages of patients with ISSs >15 (p = 0.78) or patients' need for acute care (p = 0.32) between early and late periods. A severity analysis revealed that male sex (adjusted odds ratio [aOR] 1.7 [95% confidence interval (CI): 1.2-2.4], p = 0.001) and E-bike riders compared to P-scooter riders (aOR 1.5 [95% CI:1.1-2.0], p = 0.005) were independent predictors for severe trauma.

CONCLUSIONS

The incidence of E-bike and P-scooter injuries sharply increased over time, with a parallel elevation in numbers of hospitalizations, surgical interventions, and major trauma cases. Major trauma percentages did not increase during the study period. Male sex and E-bikes emerged as independent predictors for major trauma.

E-scooter-related dental injuries: a two-year retrospective review

Introduction In June 2020, the United Kingdom (UK) published guidance on electric scooter (e-scooter) use to ease transport congestion and reduce pollution. This study aims to examine dental injuries sustained during the two years following initiation of the trial.Methods The research was conducted at a UK, Level 1, supra-regional major trauma centre. All eligible patient records were analysed to identify e-scooter-related dental injuries to the following regions: teeth, periodontium, alveolus, palate, tongue, floor of mouth, frenum, buccal mucosa and lips. To assess significant associations between recorded variables, a Pearson's chi-square test was utilised.Results Of the 32 patients who experienced a total of 71 dental injuries, 46.5% (n = 33) affected teeth, predominantly upper central incisors (n = 17). 'Lacerations' (n = 32) and 'lips' (n = 30) were the most common type and site of soft tissue injuries, respectively. Unprovoked falls by riders accounted for 53.1% (n = 17) of the injuries. There was an overall increase in e-scooter-related dental injuries throughout the two-year period.Conclusion E-scooters have introduced an additional source of dental trauma. It is imperative health care professionals can also identify signs of head and non-dental injuries when managing such patients. Further studies are warranted allowing for better informed and optimised dental public health interventions.

Characteristics and Injury Patterns in Traumatic Brain Injury Related to E-Scooter Use in Riga, Latvia: Multicenter Case Series

Background and Objectives: In recent years, electronic scooters (e-scooters) have gained popularity, whether for private use or as a publicly available transportation method. With the introduction of these vehicles, reports of e-scooter-related accidents have surged, sparking public debate and concern. The aim of this study was to analyze the epidemiological data, characteristics, and severity of traumatic brain injury (TBI) related to e-scooter accidents. Materials and Methods: This retrospective case series evaluated patients who were admitted to the three largest neurosurgery clinics in Riga, Latvia, from the time period of April to October in two separate years-2022 and 2023-after e-scooter-related accidents. The data were collected on patient demographics, the time of the accident, alcohol consumption, helmet use, the type of TBI, other related injuries, and the treatment and assessment at discharge. Results: A total of 28 patients were admitted with TBI related to e-scooter use, with a median age of 30 years (Q1-Q3, 20.25-37.25), four individuals under the age of 18, and the majority (64%) being male. In 23 cases, the injury mechanism was falling, in 5 cases, collision. None were wearing a helmet at the time of the injury. Alcohol intoxication was evident in over half of the patients (51.5%), with severe intoxication (>1.2 g/L) in 75% of cases among them. Neurological symptoms upon admission were noted in 50% of cases. All patients had intracranial trauma: 50% had brain contusions, 43% traumatic subdural hematoma, and almost 30% epidural hematoma. Craniofacial fractures were evident in 71% of cases, and there were fractures in other parts of body in three patients. Six patients required emergency neurosurgical intervention. Neurological complications were noted in two patients; one patient died. Conclusions: e-scooter-related accidents result in a significant number of brain and other associated injuries, with notable frequency linked to alcohol influence and a lack of helmet use. Prevention campaigns to raise the awareness of potential risks and the implementation of more strict regulations should be conducted.

The Impact of the City of Miami's Decision to Revoke Electric Scooter Company Permits on Orthopedic Trauma at a Level I Trauma Center

BACKGROUND

Since the introduction of electric-scooter (e-scooter) mobile applications, there has been a marked increase in e-scooter-related injury. On January 19, 2022, the City of Miami revoked permits to five major mobile applications for violation of safety protocols.

OBJECTIVES

The purpose of our study was to assess the effects of this notice on the orthopedic patients seen at our corresponding Level I trauma center.

METHODS

Institutional Review Board approval was obtained for this study. A retrospective chart review was performed including all patients with orthopedic injuries at our Level I trauma center between July 19, 2021 and July 19, 2022. These dates include 6 months prior to and after the major e-scooter operators ceased use in Miami. SPSS statistical software version 28.0.0 (SPSS, IBM, Armonk, NY) was utilized for all statistical analysis.

RESULTS

There were 2558 patients in the prenotice cohort, and 2492 patients in the postnotice cohort. After the notice, there was a significant decrease in the number of patients that presented to our institution due to injuries caused by e-scooters (2.8% vs. 1.8% patients; p = 0.021). Patients with injuries caused by e-scooters had a significantly lower age (38 vs. 42, respectively; p = 0.034) and were more likely to be male (79.3% vs. 67.4% male, respectively; p = 0.007) than patients with other orthopedic injuries.

CONCLUSION

This study demonstrates that the 2022 notice revoking the major mobile application operators from the City of Miami resulted in a significant decrease in the number of orthopedic cases due to e-scooter-related injury at the corresponding Level I trauma center.

Injury severity analysis of single-vehicle and two-vehicle crashes with electric scooters: A random parameters approach with heterogeneity in means and variances

In recent years, the electric scooter has become one of the most popular means of transportation on short trips. Due to the lag in the formulation of transportation policies and regulations, coupled with the increasing number of electric scooter crashes, there has been growing concern about the safety of pedestrians and electric scooter riders. For the first time in the extant literature, this study aims to analyze injury severity of electric scooter crashes by unobserved heterogeneity modeling approaches. A random parameters approach with heterogeneity in means and variances is utilized to examine the factors influencing injury severity, using data collected from the STATS19 road safety database. Electric scooter crashes are classified as single-vehicle crashes and two-vehicle crashes, with injury severity categorized into two groups: fatalities or serious injuries, and slight injuries. The model estimation was conducted by considering several variables including roadway, environment, temporality, vehicle, and rider characteristics, as well as second-party vehicle and driver characteristics and manners of collision specific to two-vehicle crashes. The results of the model estimation reveal that certain factors had relatively stable effects with the varying degree of crash injury severity outcomes in both single-vehicle crashes and two-vehicle crashes. These factors include nighttime incidents, weekdays, male riders, and an increase in rider age, all of which are associated with more severe injury outcomes. Moreover, the random parameters logit model with heterogeneity in means and variances is more flexible in accounting for unobserved heterogeneity and exhibits better goodness of fit. This study improves the understanding of electric scooter safety, and the finding can better inform public policy regarding electric scooter use to improve road safety and reduce injury severity of electric scooter crashes.

Unveiling the Surge: A Comprehensive Analysis of E-Scooter-Related Injuries at an Urban Level 1 Trauma Center in Vilnius, Lithuania (2018-2021)

Background The surge in electric scooter (e-scooter) adoption in 2019 fueled by sharing platforms has raised safety concerns, leading to an increased incidence of e-scooter-related injuries. Despite regulatory efforts, there has been a notable rise in accidents, prompting a comprehensive investigation. This study conducted at the Republican Vilnius University Hospital (RVUH), a level 1 trauma center, is one of the first in the Baltic States aiming to analyze the causes, severity, and frequency of e-scooter injuries from 2018 to 2021. This research addresses a critical gap in understanding e-scooter safety in the Baltic States, providing valuable insights for informed policy and preventive measures. Methodology This retrospective study analyzed e-scooter-related injuries in Vilnius, Lithuania, from April to September during 2018-2021. Data from the RVUH emergency department were examined. Using keywords such as "scooter" and "electric," relevant cases were extracted from the RVUH electronic health system. Included were individuals, both riders and pedestrians, with clear e-scooter involvement, excluding duplicates, those under 18, and users of other types of scooters. Extracted medical records provided data on demographics, injury specifics, helmet use, alcohol consumption, and more. Trauma severity was assessed through the New Injury Severity Score (NISS) and Abbreviated Injury Scale (AIS). Statistical analysis utilized GraphPad Prism software and Excel, adhering to ethical guidelines with RVUH Bioethics Committee approval. Results Over four years, 1,036 e-scooter-related injuries at RVUH revealed a gender-based shift, with males sustaining more injuries. The introduction of rentals in 2019 triggered a 334% surge in injuries compared to 2018. Despite an annual 208% increase from 2018 to 2021, 2021 saw a 710.93% rise. Trauma severity remained consistent, with AIS scores 1 and 2 being prevalent. Non-helmet wearers constituted 97.97%, and soft tissue damage was predominant. Ownership patterns shifted toward rentals (81.15%), reflecting the popularity of sharing platforms. Alcohol influence showed no significant change, but intoxicated patients had a higher surgery rate during four years. Mechanism analysis highlighted tripping as the primary cause. Injury characteristics revealed fractures in 34.56% of cases, primarily affecting upper limbs (53.35%). Soft tissue trauma was prominent (65.44%), with lower limbs being significantly impacted. Conclusions The surge in e-scooter injuries demands urgent preventive action. While most injuries are mild, a significant proportion is moderate to severe, even fatal. Inadequate education, lax enforcement, and uneven infrastructure contribute to the risk. Urgent measures, including road maintenance, speed reduction, and mandatory helmet use, are crucial. Clarity in government directives for designated e-scooter areas is vital. Further research is needed to understand the broader impact of informed policymaking and safer urban mobility. Expanding research to other Lithuanian regions would enhance the current study.

Maxillofacial trauma caused by e-scooters: a retrospective review prior to the extension of the UK scheme

The nationwide extension of the electric scooter (e-scooter) scheme, which began in 2020, aimed to alleviate public transport congestion, to reduce pollution and peak-time road traffic. This retrospective study evaluates the range of e-scooter-related maxillofacial trauma before the recent scheme extension and compares the findings with existing literature on this topic. The Queen Elizabeth Hospital Birmingham, United Kingdom (UK) operates as a Level 1 Regional Major Trauma Centre and serves a population of four million. All patient records between September 2021 to September 2022 were analysed to establish the types of e-scooter-related maxillofacial trauma sustained. A Pearson's chi-squared test was used to assess for significant associations between variables recorded. Falls accounted for the majority of injuries (44.3%), and soft tissue lacerations were the most common maxillofacial injury (38%). Statistically significant results were measured in the following variables: gender and intoxication status (p = 0.007), helmet status and injuries sustained in maxillofacial and non-maxillofacial regions (p = 0.043), mechanism of injury and injuries sustained in both the maxillofacial and non-maxillofacial regions (p = 0.045). E-scooters are an emerging concern within the UK. Further studies across the UK are required to assess the frequency of e-scooter-related injuries. Such data may prove useful in determining the government's decision on e-scooter use on UK roads.

Electric scooter-associated orthopedic injuries cause long absence from work, regret and are emerging as a major cause of hip fractures in young individuals: a comprehensive study from a regional trauma center in a densely populated urban setting

PURPOSE

This study aimed to give a full spectrum of orthopedic injuries associated with electric scooter (e-scooter) use and analyze related factors, report on follow-up data from the patient's perspective and make a comparative etiological analysis of young adult hip fractures.

METHODS

A total of 851 consecutive patients were admitted to the Emergency Department following e-scooter injuries between January 2021 and July 2022, of whom 188 had 214 orthopedic injuries. The demographics, injury, and incident characteristics of these patients were collected. All fractures were classified as per the AO/OTA classification. Two groups were created as operatively or conservatively treated patients and data were comparatively analyzed. Follow-up examination incorporated a survey using binary questions on patients' perspectives. An etiological comparative analysis of hip fractures in young adults admitted to the same center between 2016 and 2022 was conducted.

RESULTS

The median patient age was 25. Inexperienced drivers constituted 32% of the injured. The protective gear use rate was at 3%. Higher speed (p = 0.014) and age (p = 0.011) were significantly associated with operative treatment. A total of 39% of the operated patients could not return to preinjury physical function, while 74% regretted using an e-scooter. The most common etiological factor for traumatic young hip fractures was fall from a height between 2016 and 2020, whereas it became e-scooter accidents in 2021-2022.

CONCLUSION

The rate of e-scooter-related operative treatment is high and leaves the patient in regret (84%) and a physically limited condition (39%). A speed limit of ≤ 15 km/h could decrease the rate of operative injuries. The e-scooter was identified as the top etiological factor in the last 2 years for traumatic young hip fractures.

LEVEL OF EVIDENCE

II, Diagnostic cohort study.

Speed and Nighttime Usage Restrictions and the Incidence of Shared Electric Scooter Injuries

Importance

Electric scooter (e-scooter) crashes have become a serious health issue worldwide. The need for effective e-scooter regulations has been established in numerous instances.

Objective

To investigate the association of restrictions on top speed and nighttime usage on the incidence of e-scooter-related injuries.

Design, Setting, and Participants

A retrospective comparative cohort study of all patients with an injury related to shared e-scooter riding sustained in Helsinki, Finland. Data were collected from the electric patient database from 3 trauma hospitals representing all public hospitals treating patients with acute trauma in Helsinki. Shared e-scooter injuries from 2 periods were compared: an unrestricted period (January 1 to August 31, 2021) and a restricted period (January 1 to August 31, 2022). Data were analyzed from September 2022 to September 2023.

Exposures

The restrictions established for shared e-scooters during the restricted period were: (1) the daytime top speed of 20 km/h, as opposed to the previous top speed of 25 km/h, (2) the use of shared e-scooters was prohibited on Friday and Saturday nights between 12 am and 5 am, and (3) the nighttime top speed was decreased to 15 km/h from Sunday to Thursday between 12 am and 5 am, as opposed to 25 km/h.

Main outcome

The incidence of e-scooter injuries compared with the total trips made by e-scooters.

Results

There were 528 e-scooter injuries requiring hospital care during the unrestricted period and 318 injuries during the restricted period of similar length. The median (IQR) age of the patients in the study periods was 25 (21-32) and 28 (22-37), respectively; 308 (58%) and 191 (60%) were male, respectively. The incidence of e-scooter injuries was 19 (95% CI, 17-20) for every 100 000 rides during the unrestricted period and 9 (95% CI, 8-10) per 100 000 rides during the restricted period. In the risk analysis, the odds ratio for shared e-scooter injuries was 0.5 (95% CI, 0.4-0.6) for the restricted period when adjusted for hourly temperature, rain amount, wind speed, and visibility. After introducing the restrictions, the number of e-scooter injuries decreased significantly between 11 pm and 5 am.

Conclusion and Relevance

The number of injuries decreased after implementing restrictions on the top speed and nighttime usage of e-scooters. Similar restrictions in cities with shared e-scooter services should be explored.

Using e-scooters: An easy way to get home or a nightmare? An orthopedic perspective on e-scooter accidents

BACKGROUND

The percentage of e-scooter use quickly escalated in our community due to its convenience, low cost, and eases of use. The number of accidents causing high-energy traumas has also increased. This study aims to describe the demographic char-acteristics and fracture patterns of patients admitted to the emergency department following an e-scooter accident and to identify common, correctable factors that increased the likelihood of accidents.

METHODS

Between January 2022 and August 2022, 43 patients (20 females and 23 males) who were admitted to the emergency department after an e-scooter accident and developed extremity fractures were included. The patients were divided into 2 groups those treated surgically and conservatively. Parameters such as the time of the accident, education level of the user, alcohol use, e-scooter malfunction, and compliance with traffic rules were evaluated.

RESULTS

Accidents that led to treatment by surgery mostly occurred between 11 pm and 7 am. Surgically treated patients were mostly high school graduates. Alcohol use and recreational scooter use rates were statistically higher in the operated patients when compared to patients who were treated conservatively. The number of patients who reported a malfunction in the e-scooter was significantly lower in the operated group than in the conservative group. The rates of accidents due to non-compliance with traffic laws, driving at full speed of the e-scooter, use on the driveway, and presence of wet ground at the time of the accident were higher in the surgically treated patient group. Surgically treated patients also had a higher rate of being 1st time e-scooter users.

CONCLUSION

Although governments have introduced many regulations regarding e-scooter use, the current situation seems insufficient in solving the problem. E-scooter users should be further educated about the associated risks. Authorities should tighten their supervision of scooter rental companies and drivers. Nighttime usage conditions should be reviewed, and the use of alcohol should be controlled. The use of helmets should be mandatory. If such regulations are tightened, accident rates can be reduced or high-energy impacts from existing accidents can be avoided. The results suggest that experienced, slow, non-alcoholic, and rule-abiding drivers require less operative treatment. This article will hopefully raise awareness and improve e-scooter regulations.

E-scooter-related orthopedic injuries and the treatments applied: are these scooters a new means of transportation or a new source of trauma?

INTRODUCTION

E-scooters have become increasingly popular in Turkey due to easy accessibility. In parallel with this, the number of e-scooter-related injuries has increased gradually. The aim of this study was to determine the types of e-scooter-related orthopedic injuries, to evaluate hospitalization and surgical treatments, and to investigate the loss of work of patients and the burden incurred by the healthcare system.

MATERIALS AND METHODS

This retrospective multicentre study included all orthopaedic referrals, who were admitted to two major trauma departments in Diyarbakır from January 2022 to July 2022. Patient data were analyzed, including demographic characteristics, injury pattern, types of injury and subsequent treatment.

RESULTS

In a total of 62 patients, 105 orthopaedic injuries were identified, comprising 72.5% males and 27.5% females, with a median age of 34.21 years. Fifty-six (90.3%) patients were riders, and six were pedestrians. All associated e-scooters were rented. There were 44 fractures (41.9% of the total recorded injuries) including 8 (12.9%) open fractures. Surgery was required by 32 patients (51.6%) and 35 (56.4%) required hospital admission leading to hospitalization of 3.7 days on average. The average job loss of working patients after injury was determined as 2.4 months. Helmet use was detected in 6.4% of the e-scooter users, but no other protective equipment was detected in any of the patients. Furthermore, 19,3% of the patients had a blood alcohol level of > 10 mg/dl.

CONCLUSIONS

The injuries that may result from an e-scooter accident can have long-term hospitalization and long-term job loss in the community. This imposes a significant financial burden on the national healthcare system and adversely affects public health. There is a need for precautions to be implemented such as infrastructure organisation, increased awareness of motor vehicle riders and e-scooter riders, and increased enforcement of rule compliance including not using e scooters after alcohol consumption and the use of protective equipment.

Western Australian State Trauma Registry analysis of incidence and injury patterns associated with e-Scooter injuries: 5-year retrospective case series

BACKGROUND

Electric scooters (e-Scooters) are a form of motorized vehicle that offers cheap, efficient and environmentally friendly transportation. Increased e-Scooter utilization has been accompanied by increases in e-Scooter related injuries in multiple countries. This project describes the incidence, injury pattern, injury severity and patient factors associated with e-Scooter use from the Western Australian State Trauma Registry.

METHODS

Retrospective cohort of all trauma patients captured by the Western Australian State Trauma Registry between 01 July 2017 and 30 June 2022 were analysed. Patient demographics, helmet use, reported drug use, and injury details (including principal and additional diagnoses, ISS) were collected.

RESULTS

Eighty-one patients sustained e-Scooter related injuries between 2017 and 2022. Fifty-four (66%) of hospital admissions were recorded in 2021-2022, an annual percent change of 385.7% from the previous year. Most patients were male (80%). Median age was 40 years (IQR: 32-50). Helmet use was reported in 43% of patients. Helmet use was associated with a significantly lower odds of head injury (OR = 4.42, CI: 1.38-14.21; P = 0.01). Thirty-five percent of patients were intoxicated with either alcohol or drugs. Forty-four (54%) patients required surgery.

CONCLUSION

E-Scooter crashes are a new mechanism of injury affecting patients captured by the Western Australian State Trauma Registry. Helmet use correlated with a reduced risk of head injury.

Electric scooter accidents leading to emergency department visits: influence of alcohol and outcomes in Stockholm, Sweden

Electric scooters are a popular form of transportation, but accidents have increased with increased usage over the last years with rising health care costs as a consequence. This study aims to quantify accidents associated with the use of alcohol and to compare injuries at the emergency department (ED) among patients who have been involved in an accident involving an electric scooter. We used data from a multi-center retrospective registry-based cohort in the Swedish Traffic Accident Data Acquisition. We included all patients that had been involved in an electric scooter accident needing a visit to all EDs in Stockholm, Sweden during 2019-2020. Data on alcohol intake was manually drawn from medical files. Out of all of the 369 patients, the majority were men (n = 223, 60%) and aged below 30 years (n = 181, 49%). In all, 102 (28%) of the patients had a positive history of alcohol intake prior to the accident. Patients with alcohol intake more often arrived nighttime than those without alcohol, via ambulance (40% and 24%, respectively, p-value < 0.01). Those with alcohol intake needed to be admitted to hospital from the ED instead of being discharged more often than those withour alcohol (17% and 9%, respectively, p-value < 0.05) even if the majority still had minor injuries. Every 33,000 trips on electric scooters are statistically accompanied by an accident leading to an ED visit. We conclude that accidents with electric scooters are often associated with alcohol intake. They often demand more resources, such as an ambulance transfer and admission to hospital, and involve multiple injuries, compared to those without alcohol intake.

The Epidemiology and the Treatment of Fractures Due to Electric Scooters: A Comparison of Pediatric and Adult Age Groups

AIM

Electric scooters (e-scooters) are widely used as alternative vehicles worldwide. These light vehicles do not need a license to drive, and it is also popular among vehicles under the age of 18 among users in Turkey. This is a new term in the literature since there is an increase in accidents resulting from this overuse. This study aims to reveal the patterns and severity of orthopedic injuries resulting from using an e-scooter, especially in the pediatric population.

PATIENTS AND METHODS

 Patients who were admitted to the university hospital emergency department due to using an e-scooter and had fractures were retrospectively analyzed. Demographic data, admission times, injury mechanisms, and fracture patterns of the patients were documented.

RESULTS

Forty-nine (49.4%) of 99 patients were under 18, and 50 (50.6%) were over 18. It is seen that 58.5% (58 patients) had an accident by falling spontaneously, 37.3% (37 patients) collided with vehicles in traffic, and 4.2% had an accident by colliding with a standing object. While 59.5% of the upper extremity fractures are seen, 27.2% are lower extremity fractures. Multiple fractures were observed in 13.3%.

CONCLUSION

Pediatric population frequently uses these alternative means of transport. The pediatric group usually had upper extremity injuries, while adults mostly had lower extremity injuries. Care must be taken when children are drivers of e-scooters.

E-scooter riders and pedestrians: Attitudes and interactions in five countries

Electric scooters (e-scooters) have become a popular phenomenon internationally; however, their use has raised concerns about pedestrian safety. This study describes the possible effects of the emergence of e-scooters on pedestrians. We focus on the interaction, conflicts, crashes, and attitudes between pedestrians and e-scooter riders and pedestrians' perceived safety in the presence of e-scooters. Data were collected from e-scooter riders and non-riders (n = 3385) through an online survey in Australia, Belgium, the Czech Republic, Norway, and Sweden. Around 20-30% of e-scooter riders rode on sidewalks, whether it is allowed or not. Non-riders of e-scooters tended to report that riding an e-scooter is rather dangerous. Pedestrians, except Australian ones, perceived e-scooter riders (and e-scooter operation) as annoying. Half of the e-scooter riders had experienced a near miss at some point in the past and more than 50% of these near misses included another road user. Up to 10% of the e-scooter riders from all five countries reported having experienced a crash. On the basis of these findings, we believe that the most relevant suggestions for the implications in sustainable (urban) mobility involve separating e-scooter riders and pedestrians.

[E-scooter, e-bike and bicycle injuries in the same period-A prospective analysis of a level 1 trauma center]

BACKGROUND

The actual number of accidents in e‑scooter drivers in Germany seems to be significantly higher than the current figures from the Statistisches Bundesamt suggest. This epidemiological study examines e‑scooter injuries and compares them with e‑bike and bicycle injuries.

OBJECTIVE

In order to create a comparable database on the dangers of e‑scooters, e‑bikes and bicycles, the typical injury patterns were analyzed and prevention options derived from them.

MATERIAL AND METHODS

All accidents involving e‑scooters, e‑bikes and bicycles that were presented via the university emergency room of a level 1 trauma center between 15 June 2019 and 31 October 2020 were prospectively investigated.

RESULTS

In our study, 68 accidents in e‑scooter drivers were included, of which only 11.8% (n = 8) were recorded by the police. Significantly more of them were male than female (p = 0.032) with a mean age of 31.1 (±13) years. At the same time, we registered 34 accidents in e‑bike riders and 356 in cyclists. In all three groups, most injuries occurred to the head, followed by injuries to the upper extremities. Significantly more e‑scooter drivers had an ISS ≥ 16 than in the group of injured cyclists (p = 0.016). E‑scooter riders who had an accident had a significantly longer length of stay in hospital, than e‑bike riders (p = 0.003) and cyclists (p = 0.001), 52.9% (n = 18) of e‑bike riders and 53.3% (n = 113) cyclists wore a helmet, compared to only 1.5% (n = 1) of e‑scooter riders. The most common cause of accidents among e‑bike riders (17.7%; n = 6) and cyclists (10.4%; n = 37) was slipping away on tram rails, while for e‑scooter riders it was colliding with a curb (7.4%; n = 5).

CONCLUSION

The three patient collectives examined showed different causes and profiles of injuries. The reasons for an increased proportion of seriously injured people compared to cyclists are electromobility, driving under the influence of alcohol and inadequate wearing of a helmet on e‑scooters when head injuries dominate. 73.5% (n = 50) of the e‑scooter accidents recorded by us were not registered by the police and therefore do not appear in the current statistics of the statistisches Bundesamt. As a result, a much higher number of e‑scooter accidents can be assumed. Preventive measures could include the introduction of compulsory helmets, a higher number of traffic controls and the expansion of bike tracks.

Head-ground impact conditions and helmet performance in E-scooter falls

OBJECTIVE

Head injuries are common injuries in E-scooter accidents which have dramatically increased in recent years. The head impact conditions and helmet performance during E-scooter accidents are barely investigated. This study aims to characterize the head-ground impact biomechanics and evaluate bicycle helmet protection in typical E-scooter falls.

METHOD

The finite element (FE) model of a hybrid III dummy riding an E-scooter was developed and validated. The FE model with and without a bicycle helmet was used to reproduce twenty-seven E-scooter falls caused by the collision with a curb, in which different riding speeds (10, 20, and 30 km/h), curb orientations (30, 60, and 90°), and E-scooter orientations (-15, 0, and 15°) were simulated. Head-ground impact velocities and locations were evaluated for the unhelmeted configurations while the helmet performance was evaluated with the reduction of head injury metrics.

RESULTS

E-scooter falls always resulted in an oblique head-ground impact, with 78 % on the forehead. The mean vertical and tangential head-ground impact velocities were respectively 5.7 ± 1.5 m/s and 3.7 ± 2.0 m/s. The helmet significantly (p < 0.1) reduced the head linear acceleration, angular velocity, HIC_36, and BrIC, but not the angular acceleration. However, even with the helmet, the head injury metrics were mostly above the thresholds of severe head injuries.

CONCLUSION

Typical E-scooter falls might cause severe head injuries. The bicycle helmet was efficient to reduce head injury metrics but not to prevent severe head injuries. Future helmet standard evaluations should involve higher impact energy and the angular acceleration assessment in oblique impacts.

Trauma Characteristics Associated with E-Scooter Accidents in Switzerland-A Case Series Study

E-scooters have gained popularity worldwide in the last few years. Due to the increase in users, more accidents related to e-scooters can be observed. The present study aimed to analyse epidemiological data, characteristics, and severity of injuries in patients admitted to a Level I trauma centre in Switzerland (Inselspital Bern, University Hospital Bern) after accidents associated with e-scooters. This retrospective case series evaluated 23 patients who presented to the University Hospital of Bern between 1 of May 2019 and 31 of October 2021 after an e-scooter accident. Data were collected on patient demographics, time and cause of the accident, speed, alcohol consumption, helmet use, type and localisation of injury, number of injuries per patient, and outcome. Men were most frequently affected (61.9%). The mean age was 35.8 (STD 14.8) years. Slightly more than half (52.2%) of all accidents were self-inflicted. Most accidents were reported during the night (7 p.m. to 7 a.m., 60.9%) and in summer (43.5%). Alcohol consumption was reported in 43.5% of cases, with a mean blood alcohol level of 1.4 g/l. Most injuries were observed in the face (25.3%) and head/neck area (20.25%). Skin abrasions (56.5%) and traumatic brain injury (43.5%) were the most common types of traumata in terms of total number of patients. Only in one case it was reported that a protective helmet had been worn. Five patients required hospitalisation and four patients underwent surgery. Three patients underwent emergency orthopaedic surgery, and one patient underwent emergency neurosurgery. E-scooter accidents result in a significant number of facial and head/neck injuries. E-scooter riders would potentially benefit from a helmet to protect them in the event of an accident. Additionally, the results of this study indicate that a significant number of e-scooter accidents in Switzerland occurred under the influence of alcohol. Prevention campaigns to raise awareness of the risks of driving e-scooters under the influence of alcohol could help prevent future accidents.

Oral and maxillofacial injuries associated with e-scooter use at Broomfield Hospital: a cohort study of 24 months of data since e-scooter legalisation in the UK

Introduction Rental electronic scooters (e-scooters) were legalised in July 2020 in the UK for use on public roads. This has led to higher numbers of emergency department (ED) attendances for head and neck injuries managed by the oral and maxillofacial surgical (OMFS) department.Aim The aim of this research is to assess the increase in e-scooter injuries requiring OMFS input and analyse factors and management associated.Method Data were collected over a 24-month period. A total of 212 e-scooter-related ED presentations were recorded, with 34 patients requiring input from the OMFS department. For the patients referred to OMFS, numerical and categorical factors used independent T-tests and one-way Analysis of Variance tests, respectively, to determine statistical significance at the 5% confidence level (p <0.05).Results The mean age was 32.8 years (SD = 15.9) in a predominately male cohort (79.4%). Alcohol intoxication was observed in 55.8% of accidents. Injuries were most common on Saturdays (41.2%). Soft tissue injuries were present in 64.7% of patients, bony injuries in 38.2% of patients and dental injuries in 11.8% of patients. Imaging was required for 76.5% of patients. In total, 44% of patients required surgical treatment, 5.9% required major surgery and 38.2% required minor surgery.Conclusion This research supports the literature suggesting significant growth in e-scooter-related injuries and their associated burden of conditions managed by the OMFS department.

Electric Scooter-Related Upper Limb Fractures: Analysis of 458 Cases

PURPOSE

To perform an analysis of electric scooter (e-scooter)-related upper limb fractures (ULFs), which have increased dramatically in parallel with the rapid rise in the use of e-scooters and shared e-scooter services in recent years.

METHODS

We retrospectively reviewed the medical charts of e-scooter-related emergency department visits between January 2017 and January 2020 at a level I trauma center. All patients with ULFs were included in the study, and their data were analyzed for demographics, fracture diagnosis, associated injuries, and required surgical treatment.

RESULTS

This study included 356 patients (50% men) with 458 ULFs, of which 23 (5%) were open fractures. The mean age of the cohort was 32.9 years (standard deviation, 10.1 years). The most common mechanism of injury was rider fall (92.1%). The nondominant hand was injured in 53.1% of cases, and 32.1% of all fractures were treated with surgery. A total of 120 (33.7%) patients sustained more than 1 ipsilateral ULF, and 27 (7.6%) patients had a concomitant contralateral ULF. Radial head fracture was the most common fracture type (n = 123, 26.8%), of which 16 (13%) were bilateral. The fifth ray was injured most frequently among the metacarpal and phalangeal fractures (n = 33, 47.1%). Most of the nonextremity-associated injuries were those of the head and maxillofacial bones.

CONCLUSIONS

The most common ULF associated with e-scooters was the radial head fracture. Physicians should be alert to and seek associated fractures during initial assessments of e-scooter-related upper limb injuries. Further investigation may be warranted to evaluate the effectiveness of protective measures in reducing the number of injuries.

TYPE OF STUDY/LEVEL OF EVIDENCE

Therapeutic IV.

Risk factors and injury patterns of e-scooter associated injuries in Germany

Since the introduction of widely available e-scooter rentals in Hamburg, Germany in June of 2019, our emergency department has seen a sharp increase in the amount of e-scooter related injuries. Despite a rising number of studies certain aspects of e-scooter mobility remain unclear. This study examines the various aspects of e-scooter associated injuries with one of the largest cohorts to date. Electronic patient records of emergency department admissions were screened for e-scooter associated injuries between June 2019 and December 2021. Patient demographic data, mechanism of injury, alcohol consumption, helmet usage, sustained injuries and utilized medical resources were recorded. Overall, 268 patients (57% male) with a median age of 30.3 years (IQR 23.3; 40.0) were included. 252 (94%) were e-scooter riders themselves, while 16 (6%) were involved in crashes associated with an e-scooter. Patients in non-rider e-scooter crashes were either cyclists who collided with e-scooter riders or older pedestrians (median age 61.2 years) who tripped over parked e-scooters. While e-scooter riders involved in a crash sustained an impact to the head or face in 58% of cases, those under the influence of alcohol fell on their head or face in 84% of cases. This resulted in a large amount of maxillofacial soft tissue lacerations and fractures. Extremity fractures and dislocations were more often recorded for the upper extremities. This study comprises one of the largest cohorts of e-scooter associated injuries to date. Older pedestrians are at risk to stumble over parked e-scooters. E-scooter crashes with riders who consumed alcohol were associated with more severe injuries, especially to the head and face. Restricted e-scooter parking, enforcement of drunk driving laws for e-scooters, and helmet usage should be recommended.

[One and a half years of e-scooters in Hamburg]

Background

Since the spread of the so-called electric scooters (e-scooters) through rental services in Hamburg as of June 2019, accidents due to the use of this means of transportation have been regularly registered. The most frequent injury patterns among e‑scooter riders involved accidents concerning the upper extremities and the head. There was a relevant accumulation of drunk drivers among the injured persons.

Objective

The aim of the study is to compare injury patterns in drunk versus non-drunk e‑scooter riders who had an accident.

Material and methods

Data from the Department of Trauma Surgery at the University Medical Center Hamburg-Eppendorf were retrospectively analyzed for accidents involving e‑scooters and the resulting injury patterns. For this purpose, the gender, age, injury pattern of the persons, the course of the accident, and information on previous alcohol consumption were recorded descriptively for the period from June 2019 to December 2021.

Results

Drivers were on average 32 (interval: 15-88 years) years old and those under the influence of alcohol were predominantly male (69.9%). Accidents occurred mainly in summer and at night. Common injury patterns were injuries to the face, head, and extremities.

Conclusion

It should be noted that injuries to the face and head occurred more frequently under the influence of alcohol than in the cohort without alcohol. Education about the health and legal consequences of riding an e‑scooter under the influence of alcohol should be provided to all users. In addition, wearing a helmet or banning driving at night are possible measures to reduce accidents associated with drunk riding.

[One and a half years of e-scooters in Hamburg]

Background

Since electric scooters were introduced as an urban means of transportation in Hamburg in June 2019, a high number of violations of the current laws regarding alcohol consumption by e‑scooter riders have been recorded.

Objective

The aim of this study is to obtain an overview of traffic offences committed by e‑scooter drivers under the influence of alcohol, to classify their relevance in relation to other road user groups, and to draw a first interim balance with respect to their frequency after 1.5 years.

Material and methods

The data of all e‑scooter drivers (n = 342) examined concerning their blood alcohol values analyzed at the Institute of Legal Medicine of the University Medical Centre Hamburg-Eppendorf between 15.06.2019 and 31.12.2020 were retrospectively evaluated with respect to their demographic information and the medical examination results. These were brought into context with the total number of offences against the road traffic regulations with subsequent blood alcohol measurement.

Results

9.6% of the total number of offences against the road traffic regulations in connection with subsequent determination of the blood alcohol concentration were committed by e‑scooter drivers. 87.7% of those examined were male. The blood alcohol concentration was above the limit of 1.10 ‰ for absolute driving incapacity when using a passenger car in 76.9% of those examined. An accumulation of cases was particularly noticeable at night and at weekends.Due to imprecise records, a certain number of unreported e‑scooter incidents can be assumed among the unspecified motor vehicles.

Conclusion

As e‑scooter drivers make up a considerable proportion of drunken road users and the accidents mostly occur at night and at weekends, increased education and, if necessary, a driving ban at these times would seem to make sense.

Neurosurgical Consequences of e-Scooter Use: Strategies to Prevent Neurological Injury

Rideshare electric scooter accidents have led to increasing emergency department (ED) visits and neurosurgical consultations. This study categorizes e-scooter-related injuries requiring neurosurgical consultation at a single level 1 trauma center. Patients who required neurosurgical consultation from June 2019 to June 2021 with a positive finding on computed tomography imaging were selected for review of patient and injury characteristics, resulting in a sample size of 50 cases. Average patient age was 36.9 (15-69) years, and 70% were male. Seventy-four percent of patients were under the influence of alcohol and 12% illicit drugs. None (0%) were helmeted. Seventy-eight percent of accidents occurred between 6:00 pm and 6:00 am. Twenty-two percent of patients required surgical intervention by craniotomy/craniectomy, and 4% required intracranial pressure monitor placement. Average intracranial hemorrhage volume was 17.8 cc (trace to 125). Volume of hemorrhage was associated with the need for an intensive care unit (ICU) stay (odds ratio [OR] = 1.01; p = 0.04), need for surgical intervention (OR = 1.007; p = 0.0001), and mortality (1.816; p < 0.001) and trended toward, but did not reach significance for, overall poor outcome (OR = 1.63; p = 0.06). Sixty-two percent of this patient pool required ICU admission. Average length of ICU stay was 3.5 days (0-35), and average length of hospital stay was 8.3 days (0-82). Mortality in this series was 8%. Lower admission Glasgow Coma Scale (OR = 0.974; p < 0.001) and increased volume of hemorrhage (OR = 1.816; p < 0.001) were associated with increased risk of mortality in the linear regression analysis. Electric scooters have become prevalent in most urban centers, and accidents are a potential source of severe intracranial injury requiring extended ICU and hospital stays, surgical intervention, and sometimes resulting in long-term morbidity and/or mortality. Injuries often occur in the evening hours and are often associated with alcohol/drug use and lack of helmet use. Policy changes to help mitigate the risk of these injuries are recommended.

Web content mining analysis of e-scooter crash causes and implications in Germany

In Germany, police reports published via press are neither uniformly written nor accessible to the public. There is a lack of comprehensive and factual data-based analyses of e-scooter crashes and their causes. We collected 1936 crash-related reports over two years via the German press portal based on a systematic web content mining process. Sentiment analysis results revealed that the police reports' coverage is predominantly factual and neutral and, therefore, useful for keyword-based analyses. After identifying the 46 most relevant keywords in the reports, we generated an adjacency matrix to investigate the keywords' dependencies, visualized the network and dependencies of the most relevant keywords, and categorized them into four thematic clusters using the Louvain algorithm. Our results and findings reveal that driving under drug influence, especially alcohol, is one serious problem. Riding e-scooter in pairs and on forbidden terrain or in the wrong direction are also common causes of crashes. Consequences for e-scooter riders are severe injuries, driving license revocation, fines, criminal charges, and incurring for property damage. Further, wearing protective gear and helmets is of low acceptance among the e-scooter ridership. Based on our results and findings, we recommend e-scooter bans during the night times for some locations, obligatory driving tests before first e-scooter use, and helmet wearing.

Characteristics and costs of electric scooter injuries in Helsinki: a retrospective cohort study

Background and purpose

The incidence of electric scooter (e-scooter) injuries has increased drastically in numerous countries after widespread availability of shared e-scooters. The economic impact on society from a broader perspective has not been studied. We aimed to estimate the incidence of e-scooter injuries, describe the injury patterns, and estimate the costs of e-scooter injuries.

Patients and methods:

We performed a retrospective cohort study including all e-scooter-related injuries presented in the three adult emergency departments in Helsinki in 2021. We collected the patient data from the university hospital information system. Injury severity was evaluated based on the Abbreviated Injury Score. The cost of the hospital treatment was analyzed based on our hospital district’s service price listing. In addition, we recorded the total amount of sick leave days and estimated their economic impact.

Results

In total, 446 e-scooter injuries were identified and taken into the analysis (434 affecting riders and 12 non-riders). The median age of the patients was 26 (IQR 22–33), and 59% were male. 257 (58%) of the of the injuries were minor, whereas 155 (35%) were moderate, 30 (7%) serious, 3 (0.7%) severe, and one (0.2%) critical. Furthermore, 220 (49%) of the patients sustained head injuries. A major spike in accident incidence was seen during the weekend (Friday to Sunday) nights, accompanied by a proportional increase in patients with alcohol intoxication. Including both the costs of the hospital care and absence from work, the approximated total cost of e-scooter injuries was 1.7 million euros, with a median cost of a single accident being 1148 euros (IQR 399–4263 €).

Interpretation:

Considerable number of the injuries are moderate, severe, or worse. Comprehensive preventive measures must be conducted to decrease the incidence of e-scooter injuries. The use of helmets should be strongly encouraged to prevent severe head injuries. The nighttime bans during weekends and speed limits on e-scooters appear to be justifiable.

Case Series and Systematic Review of Electronic Scooter Crashes and Severe Traumatic Brain Injury

OBJECTIVE

Electric scooters (e-scooters) are an increasingly popular form of transportation, but their use has also resulted in increased incidence of traumatic brain injury (TBI). Previous reports have predominantly described mild TBI with limited attention to other injury patterns. Our objective was to evaluate the impact of e-scooter use on rates of severe TBI.

METHODS

We performed a multicenter retrospective case review of patients who presented with severe TBI (Glasgow Coma Scale score 3-8) related to e-scooter use and undertook a systematic literature review to identify other reports of severe TBI related to e-scooter use.

RESULTS

Of the 19 patients (mean age, 38 ± 16 years; 73.7% male) included in the case series, 13 (68.4%) experienced a fall and 6 (31.6%) were involved in a collision. Various cerebral injury patterns, associated craniofacial fractures, and cervical spine injuries were also seen. Twelve patients (63.2%) underwent intracranial pressure monitor placement and 6 (31.6%) underwent a decompressive hemicraniectomy. Most patients (n = 12; 63.2%) were discharged to acute rehabilitation, with a median modified Rankin Scale score of 2 at 4.9 ± 7.7 months follow-up (52.6% had a good outcome of modified Rankin Scale score ≤2), but 4 patients died of primary injuries. The systematic review identified 18 studies with 77,069 patients between 2019 and 2021, with 37 patients who required intensive care and 6 patients who had neurosurgical intervention.

CONCLUSIONS

Severe TBI after e-scooter use is associated with high morbidity and is likely underdiagnosed in the literature. Awareness and public policies may be helpful to reduce the impact of injury.

Age as a Predictive Factor in Severity of Injuries in Riders of Electric Bikes and Powered Scooters: A Retrospective Cross-Sectional Study

The growth in worldwide popularity of electric bikes (E-bikes) and powered scooters (P-scooters) has been accompanied by an increase in injuries associated with their use. The aim of this study was to evaluate the contribution of rider age to injury severity, represented by need for hospitalization. A retrospective review of the database of a tertiary medical center yielded 1234 patients (75.7% male) who attended the emergency department (ED) in 2014−2020 for injuries sustained while riding an E-bike or P-scooter. Mean age was 31.52 ± 14.77 years: 23% were aged <20 years; 33%, 21−30 years; 23%, 31−40 years; 10%, 41−50 years; 11%, >51 years. Ninety patients (7.3%) were hospitalized. Older age was significantly associated with the need for hospitalization on univariate analysis (p <.001), but significance was not maintained on binary logistic regression (OR = 1.02, 95%CI 0.99−1.06; p = 0.11). Patients who underwent imaging evaluation in the ED were at lower risk of hospitalization, and patients who had surgery or a relatively long operative procedure were at higher risk of hospitalization. The study shows that older age (>51 years) is not associated with a significantly increased probability of severe injury in E-bike and P-scooter riders. This finding has important implications for insurers and healthcare administrators.

The impact of e-scooter injuries

Aims

Due to the recent rapid expansion of scooter sharing companies, there has been a dramatic increase in the number of electric scooter (e-scooter) injuries. Our purpose was to conduct a systematic review to characterize the demographic characteristics, most common injuries, and management of patients injured from electric scooters.

Methods

We searched PubMed, EMBASE, Scopus, and Web of Science databases using variations of the term “electric scooter”. We excluded studies conducted prior to 2015, studies with a population of less than 50, case reports, and studies not focused on electric scooters. Data were analyzed using t-tests and p-values < 0.05 were considered significant.

Results

We studied 5,705 patients from 34 studies. The mean age was 33.3 years (SD 3.5), and 58.3% (n = 3,325) were male. The leading mechanism of injury was falling (n = 3,595, 74.4%). Injured patients were more likely to not wear a helmet (n = 2,114; 68.1%; p < 0.001). The most common type of injury incurred was bony injuries (n = 2,761, 39.2%), of which upper limb fractures dominated (n = 1,236, 44.8%). Head and neck injuries composed 22.2% (n = 1,565) of the reported injuries, including traumatic brain injuries (n = 455; 2.5%), lacerations/abrasions/contusions (n = 500; 7.1%), intracerebral brain haemorrhages (n = 131; 1.9%), and concussions (n = 255; 3.2%). Standard radiographs comprised most images (n = 2,153; 57.7%). Most patients were treated and released without admission (n = 2,895; 54.5%), and 17.2% (n = 911) of injured patients required surgery. Qualitative analyses of the cost of injury revealed that any intoxication was associated with higher billing costs.

Conclusion

The leading injuries from e-scooters are upper limb fractures. Falling was the leading mechanism of injury, and most patients did not wear a helmet. Future research should focus on injury characterization, treatment, and cost.

Cite this article: Bone Jt Open 2022;3(9):674–683.

Trends in the Incidence and Severity of Injuries Sustained by Riders of Electric Bikes and Powered Scooters: A Retrospective Cross-Sectional Study

Background and Objectives: The worldwide increase in electric bike (E-bike) and powered scooter (P-scooter) use in recent years has been accompanied by an increase in associated injuries to riders. The aim of this study was to evaluate trends in the incidence and types of E-bikes and P-scooter-related injuries in riders evacuated to a tertiary ED. Materials and Methods: A retrospective cross-sectional design was used. The cohort included 1234 patients referred to the emergency department (ED) of a tertiary medical center in 2014–2020 for injuries sustained while riding an E-bike or P-scooter. Demographic, clinical, and injury data were collected from the medical files, and injury rates were evaluated over time. Results: The results showed that the annual number of ED visits by injured E-bike and P-scooter riders increased steadily over the study period concomitant with an increase in ED referrals for hospitalization, indicating severe injury. The upper and lower extremities were the most frequent anatomic sites of injury in every year of the study, with variations among the different age groups. Conclusions: Our findings suggest a need for safety regulations for riders who operate two-wheel powered vehicles, such as licensing requirements and mandatory protective gear, especially for anatomic sites most at risk.

Slow and Steady Wins the Race: A Comparative Analysis of Standing Electric Scooters’ European Regulations Integrated with the Aspect of Forensic Traumatology

Fuel-driven cars are widely considered unsustainable and contrary to the new paradigm of smart growth planning. The need to reform transport behavior, policies, and infrastructure is among the priorities in urban policies around the world. Electric vehicles are an emerging technology that could advance sustainability programs. In the past year, there has been a rapid increase in the diffusion of electric scooters in several European cities, but various states have been unprepared for the rapid spread of green micro-mobility from a regulatory point of view. In addition, in parallel with the spread, there have been numerous road collisions involving standing electric scooters. The aim of this study was to obtain a detailed view of this phenomenon. We focused on the current legislation on electric micro-mobility at the European level to study and summarize the different attitudes adopted by various states whose regulations are present on the web. (It was not possible to evaluate the regulations of all European countries because they are not all available on online platforms.) The elements assessed in the various regulation were age limits, speed limits, compulsory use of helmets, administrative penalties, and the obligation to insure the new e-vehicle (standing scooter). In this study, we analyze the state of the art in electric micro-mobility, highlight the current situation’s limits, and propose new strategies to adequately integrate this new smart vehicle into the urban transport network.

E-scooter related injuries: Using natural language processing to rapidly search 36 million medical notes

Background

Shareable e-scooters have become popular, but injuries to riders and bystanders have not been well characterized. The goal of this study was to describe e-scooter injuries and estimate the rate of injury per e-scooter trip.

Methods and findings

Retrospective review of patients presenting to 180 clinics and 2 hospitals in greater Los Angeles between January 1, 2014 and May 14, 2020. Injuries were identified using a natural language processing (NLP) algorithm not previously used to identify injuries, tallied, and described along with required healthcare resources. We combine these tallies with municipal data on scooter use to report a monthly utilization-corrected rate of e-scooter injuries. We searched 36 million clinical notes. Our NLP algorithm correctly classified 92% of notes in the testing set compared with the gold standard of investigator review. In total, we identified 1,354 people injured by e-scooters; 30% were seen in more than one clinical setting (e.g., emergency department and a follow-up outpatient visit), 29% required advanced imaging, 6% required inpatient admission, and 2 died. We estimate 115 injuries per million e-scooter trips were treated in our health system.

Conclusions

Our observed e-scooter injury rate is likely an underestimate, but is similar to that previously reported for motorcycles. However, the comparative severity of injuries is unknown. Our methodology may prove useful to study other clinical conditions not identifiable by existing diagnostic systems.

Alcohol intoxication and lack of helmet use are common in electric scooter-related traumatic brain injuries: a consecutive patient series from a tertiary university hospital

PURPOSE

Clinicians have increasingly encountered traumatic brain injuries (TBI) related to electric scooter (ES) accidents. In this study, we aim to identify the modifiable risk factors for ES-related TBIs.

METHODS

A retrospective cohort of consecutive patients treated for ES-related traumatic brain injuries in a tertiary university hospital between May 2019 and September 2021 was identified and employed for the study. The characteristics of the accidents along with the clinical and imaging findings of the injuries were collected from the patient charts.

RESULTS

During the study period, 104 TBIs related to ES accidents were identified. There was a high occurrence of accidents late at night and on Saturdays. In four cases, the patient's helmet use was mentioned (3.8%). Seventy-four patients (71%) were intoxicated. At the scene of the accident, seventy-seven (74%) of the patients had a Glasgow Coma Scale score of 13-15, three patients (3%) had a score of 9-12, and two patients (2%) had a score of 3-8. The majority (83%) of TBIs were diagnosed as concussions. Eighteen patients had evidence of intracranial injuries in the imagining. Two patients required neurosurgical procedures. The estimated population standardized incidence increased from 7.0/100,000 (95% CI 3.5-11/100,000) in 2019 to 27/100,000 (95% CI 20-34/100,000) in 2021.

CONCLUSIONS

Alcohol intoxication and the lack of a helmet were common in TBIs caused by ES accidents. Most of the accidents occurred late at night. Targeting these modifiable factors could decrease the incidence of ES-related TBIs.