1
|
McLaughlin SA, Davila N, Bineshfar N, Pradeep T. Risk Factors for Eye and Orbital Injuries Related to Electric Scooters and Off-Road Vehicles. Semin Ophthalmol 2025; 40:239-245. [PMID: 39545872 DOI: 10.1080/08820538.2024.2429633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Revised: 11/05/2024] [Accepted: 11/08/2024] [Indexed: 11/17/2024]
Abstract
PURPOSE Electric scooters (e-scooters) have rapidly become a mainstream method of transportation in the U.S. but there is consequently limited data on their safety profile. This study evaluates ophthalmic injuries related to e-scooters compared to non-motorized scooters and off-road vehicles (ORV). METHODS This retrospective study uses the National Electronic Injury Surveillance System (2014 to 2023). Ocular injury profiles associated with conventional scooters, e-scooters, and off-road vehicles were included. RESULTS E-scooter ocular injuries rose by 1950% between 2014 and 2023. E-scooter riders were 4.3 times more likely to sustain orbital fractures and 2.7 times more likely to be hospitalized than non-motorized scooter riders. ORV and e-scooter riders had comparable injury and hospitalization patterns. Alcohol use and lack of helmet use were significant contributors to injury severity. CONCLUSIONS AND RELEVANCE Injury patterns and hospitalization rates in e-scooter accidents resemble those of ORV incidents. Findings highlight the need for public health interventions to reduce the burden of e-scooter-related injuries.
Collapse
Affiliation(s)
- Samantha A McLaughlin
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Natalia Davila
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, USA
| | - Niloufar Bineshfar
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Tejus Pradeep
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
2
|
Snäll J, Vasara H, Murros OJ, Harjola VP, Castrén M, Puolakkainen T. Changes in e-scooter related maxillofacial injuries following legislative measures in Helsinki, Finland. Sci Rep 2025; 15:9720. [PMID: 40119002 PMCID: PMC11928615 DOI: 10.1038/s41598-025-94602-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2024] [Accepted: 03/14/2025] [Indexed: 03/24/2025] Open
Abstract
The increasing use of e-scooters globally has resulted in a rise in traffic-related injuries, particularly maxillofacial trauma. This study assesses the potential impact of legislative measures, specifically speed limits and night-time usage restrictions, on reducing maxillofacial injuries from e-scooter accidents. A retrospective cohort study was conducted using data from patients treated for e-scooter-related injuries at Helsinki University Hospital between January 2021 and December 2023. The study included 1275 patients, aged ≥ 16 years, treated in three trauma hospitals. Patients not riding e-scooters at the time of injury were excluded. Injury patterns and the influence of legislative measures were analyzed. Among the 1275 patients, 169 (13.3%) sustained maxillofacial injuries. Legislative restrictions were associated with a significant reduction in maxillofacial injuries, with up to an 88% decrease in some months. Predictors of maxillofacial injuries included older age (OR 1.06, 95% CI 1.04-1.08), alcohol intoxication (OR 3.2, 95% CI 1.5-5.8), and concurrent head and neck injuries (OR 12.1, 95% CI 5.8-25.2). Legislative restrictions on e-scooter use, including speed limits and nighttime riding bans, were associated with a significant reduction in maxillofacial injuries. These findings highlight the importance of targeted policies to mitigate injury risks associated with e-scooter use.
Collapse
Affiliation(s)
- Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki, P.O. Box 100, 00290, Helsinki, Finland
- Helsinki University Hospital, Helsinki, Finland
| | - Henri Vasara
- Department of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Olli-Jussi Murros
- Department of Oral and Maxillofacial Diseases, University of Helsinki, P.O. Box 100, 00290, Helsinki, Finland
- Helsinki University Hospital, Helsinki, Finland
| | - Veli-Pekka Harjola
- Department of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Maaret Castrén
- Department of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tero Puolakkainen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, P.O. Box 100, 00290, Helsinki, Finland.
- Helsinki University Hospital, Helsinki, Finland.
| |
Collapse
|
3
|
Black KM, Santorelli JE, Costantini TW, Kobayashi LM, Doucet JJ, Haines LN. From Peril to Protection: an evaluation of regulations impacting eScooter injuries. Trauma Surg Acute Care Open 2025; 10:e001440. [PMID: 39944560 PMCID: PMC11815460 DOI: 10.1136/tsaco-2024-001440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 01/22/2025] [Indexed: 02/25/2025] Open
Abstract
Background The use of standing electric motorized scooters (eScooters) has skyrocketed since its first release in 2016. This quickly popularized form of transportation has been associated with significant injury and even death. These eScooter-related traumatic injuries led to local advocacy efforts, resulting in safety restrictions including speed limit geofencing, sidewalk restrictions, and limiting the number of eScooter providers in high-density population areas. We hypothesized that these local safety restrictions decreased the number of eScooter-related injuries presenting to our trauma center. . Methods This is a retrospective cohort study of eScooter-crash patients presenting to our Level 1 trauma center from July 2018 to June 2023. Variables included patient demographics, injury severity score (ISS), and mortality. The primary outcome was the rate of eScooter patients presenting over time in relation to the implementation of local-regional safety regulations. Results A total of 381 patients presented after eScooter crashes. Males were 73.8% of patients. The average age was 38.6 years; 45+ years was the most common age group at 33%, followed by ages 25-34 (31%). The mean ISS was 9±6, with ISS 0-9 (65.1%), 10-15 (24.4%), 16-24 (8.4%), and >25 (20.1%). There were three (0.8%) deaths. The median number of eScooter patients per month with prespeed limits was nine and post five (p=0.005), showing a 44.4% decrease in injured patients. After February 2022 restrictions, the rate precipitously declined with a median of two (p=0.033), reflecting an additional 60% decrease in injured patients. Conclusion Local advocacy resulting in increased safety regulations was associated with a significant reduction in injured patients secondary to eScooter use. This demonstrates the importance of advocacy efforts in response to changes in injury patterns and mechanisms of injury. We believe that our work can serve as a model for other urban centers seeking to reduce eScooter-related injuries and implement effective safety measures. Level of evidence IV, prognostic/epidemiologic.
Collapse
Affiliation(s)
- Kendra M Black
- Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California San Diego, San Diego, California, USA
| | - Jarrett E Santorelli
- Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California San Diego, San Diego, California, USA
| | - Todd W Costantini
- Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California San Diego, San Diego, California, USA
| | - Leslie M Kobayashi
- Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California San Diego, San Diego, California, USA
| | - Jay J Doucet
- Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California San Diego, San Diego, California, USA
| | - Laura N Haines
- Department of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California San Diego, San Diego, California, USA
| |
Collapse
|
4
|
Hartz F, Zehnder P, Resch T, Römmermann G, Hartmann V, Schwarz M, Kirchhoff C, Biberthaler P, Zyskowski M. Characteristics of e-scooter and bicycle injuries at a university hospital in a large German city - a one-year analysis. Inj Epidemiol 2025; 12:2. [PMID: 39789651 PMCID: PMC11721586 DOI: 10.1186/s40621-024-00554-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2024] [Accepted: 12/23/2024] [Indexed: 01/12/2025] Open
Abstract
BACKGROUND The increasing adoption of individual urban mobility in European cities is contributing to a rise in the number of bicycle and e-scooter users. Consequently, a corresponding increase in accidents, along with an additional burden on emergency departments, is anticipated, particularly in metropolitan areas. The objective of this prospective cross-sectional study was to gather detailed information regarding the patient demographics, accident mechanisms, and injury patterns of e-scooter riders in comparison to cyclists. Identifying any differences between these groups will provide a foundation for developing targeted prevention strategies and safety measures aimed at reducing the incidence of accidents and injuries. METHODS All patients who presented to the emergency department of our level I university trauma center after an accident involving a traditional bicycle without electric assistance or an e-scooter in 2022 were recorded. Demographic data as well as information regarding the trauma mechanism, injury pattern, alcohol influence, treatment requirements and helmet use were analyzed and compared between the two groups. RESULTS In 2022, a total of 626 patients were identified after a bicycle accident and 98 patients after an e-scooter accident. E-scooter riders were with a mean age of 31.0 years (standard deviation (SD) 10.7) significantly younger compared to bicycle riders at 43.2 years (SD 16.5; p < 0.001). More than half of the patients in both groups were male (e-scooter 69.4% versus bicycle 60.7%). E-scooter riders were more likely to be intoxicated (31.6% vs. 5.4%; p < 0.001), not wearing a helmet (93.9% vs. 78.4%; p < 0.001) and to have had accidents at nighttime (39.8% vs. 11.5%; p < 0.001). There was no significant difference between the distribution of minor (e-scooter 75.2% vs. bicycle 70.3%) and major (24.8% vs. 29.7%) injuries. In terms of body regions, e-scooter riders suffered from major injuries to the skull, facial cranium, cervical spine (43.8% e-scooter vs. 22.4% bicycle; p = 0.008) and less frequently to the trunk, thoracic and lumbar spine and pelvis (0.0% vs. 13.6%). CONCLUSION Compared to cyclists, injured e-scooter riders are younger, mostly do not wear a helmet and more often ride under the influence of alcohol. E-scooter accidents occur more frequently at night and the riders are more likely to suffer serious head injuries.
Collapse
Affiliation(s)
- Frederik Hartz
- Department of Trauma Surgery, TUM University Hospital Klinikum Rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany.
| | - Philipp Zehnder
- Department of Trauma Surgery, TUM University Hospital Klinikum Rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| | - Tobias Resch
- Department of Trauma Surgery, TUM University Hospital Klinikum Rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| | - Gregor Römmermann
- Department of Trauma Surgery, TUM University Hospital Klinikum Rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| | - Victoria Hartmann
- Department of Trauma Surgery, TUM University Hospital Klinikum Rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| | - Markus Schwarz
- Department of Trauma Surgery, TUM University Hospital Klinikum Rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| | - Chlodwig Kirchhoff
- Department of Trauma Surgery, TUM University Hospital Klinikum Rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| | - Peter Biberthaler
- Department of Trauma Surgery, TUM University Hospital Klinikum Rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| | - Michael Zyskowski
- Department of Trauma Surgery, TUM University Hospital Klinikum Rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| |
Collapse
|
5
|
Kumar S, Lee P, Zagales R, Yates Z, Haddadi M, Strouse J, Zito T, Elkbuli A. A comprehensive review of current trends in e-scooter associated injuries, associated outcomes, and effective interventions: Towards establishing sustainable prevention interventions. Injury 2024; 55:111967. [PMID: 39490148 DOI: 10.1016/j.injury.2024.111967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 09/24/2024] [Accepted: 10/14/2024] [Indexed: 11/05/2024]
Abstract
INTRODUCTION This review aims to provide a comprehensive overview of electric-scooter (E-Scooter) injuries by evaluating the incidence, common mechanisms of injury, clinical outcomes, associated costs, and effective interventions for injury prevention. METHODS A literature search using PubMed, Google Scholar, EMBASE, and ProQuest was performed to identify relevant articles published between July 10, 2014, and July 10, 2024. Outcomes of interest included epidemiologic trends of E-Scooter injuries, common mechanisms of injury, associated risk factors, clinical outcomes, and interventions to decrease E-Scooter injuries. RESULTS A total of 41 articles were included in this study, with 39 evaluating the epidemiologic trends of e-scooter injuries, 22 the most common mechanisms of injury, 21 assessed intoxication, 15 assessed helmet usage, 33 determined patient's clinical outcomes, and 3 assessed effective interventions for decreasing the incidence of e-scooter injuries. Falls were the most common mechanism of injury; however, collisions with motor vehicles caused more severe injuries. Additionally, studies showed that up to 74 % of all E-Scooter injuries included alcohol intoxication, and over 80 % did not use a helmet leading to severe head injuries. CONCLUSION The incidence of E-Scooter related injuries rose significantly in recent years. These injuries typically result from falls and MVAs and are compounded by factors including limited helmet usage and riding while intoxicated. These contribute to the poorer clinical outcomes seen with E-Scooter injuries. However, there remains a significant paucity of literature focused on the outcomes of policies and interventions designed to reduce these injuries. Further investigation must address these gaps and discrepancies to inform future policies.
Collapse
Affiliation(s)
- Sanjan Kumar
- University of Central Florida College of Medicine, Orlando, FL, USA
| | - Philip Lee
- University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii, USA
| | - Ruth Zagales
- Indiana University School of Medicine, Indiana, USA
| | - Zackary Yates
- University of Central Florida College of Medicine, Orlando, FL, USA
| | - Minna Haddadi
- American University of Antigua College of Medicine, Coolidge, Antigua and Barbuda
| | - Jacob Strouse
- Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Tracy Zito
- Department of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, FL, USA; Department of Surgical Education, Orlando Regional Medical Center, Orlando, FL, USA
| | - Adel Elkbuli
- Department of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, FL, USA; Department of Surgical Education, Orlando Regional Medical Center, Orlando, FL, USA.
| |
Collapse
|
6
|
Dibaj S, Vosough S, Kazemzadeh K, O'Hern S, Mladenović MN. An exploration of e-scooter injuries and severity: Impact of restriction policies in Helsinki, Finland. JOURNAL OF SAFETY RESEARCH 2024; 91:271-282. [PMID: 39998529 DOI: 10.1016/j.jsr.2024.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 06/11/2024] [Accepted: 09/06/2024] [Indexed: 02/27/2025]
Abstract
INTRODUCTION The emergence of shared electric scooter (e-scooter) services has introduced a new mobility option in numerous urban areas worldwide. Safety concerns surrounding e-scooter riding have prompted some cities to impose bans or restrictions on shared e-scooters. This study aims to assess the impact of e-scooter restriction policies, on the spatiotemporal distribution of e-scooter injuries and factors influencing injury severity in Helsinki, Finland, in 2021 and 2022. These restrictions include banning shared e-scooter use from midnight to 5 a.m. on weekends and reducing speeds during certain hours. METHOD This study employed an ordered logit model, heatmap analysis of crash locations, and temporal analysis across different time frames to achieve these objectives. RESULTS The findings indicate a 64% reduction in the number of e-scooter injuries after the restrictions. However, the severity of injuries experienced only a slight decrease. Notably, the trend of injury severity appeared smoother in 2022 compared to 2021, with spikes occurring from Friday to Sunday. The spatial distribution of crashes revealed that, in 2021, most crashes were concentrated in the city center, while in 2022, the crash locations were more scattered, partly due to the increased area serviced by e-scooters. The results also underscored the substantial impact of alcohol intoxication, as it significantly increased the probability of more severe injuries. Furthermore, higher age groups and people using e-scooters from 4 p.m. to 9 p.m. are more likely to experience higher injury severity after the restrictions were implemented. These research outcomes offer valuable insights for other cities, providing lessons on how to tailor policies to effectively reduce the number of e-scooter-related injuries.
Collapse
Affiliation(s)
- Samira Dibaj
- Department of Built Environment, School of Engineering, Aalto University, Espoo, Finland; Institute for Transport Studies, University of Leeds, Leeds, UK.
| | - Shaghayegh Vosough
- Department of Built Environment, School of Engineering, Aalto University, Espoo, Finland.
| | - Khashayar Kazemzadeh
- Civil Engineering Division, Department of Engineering, University of Cambridge, Cambridge, United Kingdom.
| | - Steve O'Hern
- Institute for Transport Studies, University of Leeds, Leeds, UK.
| | - Miloš N Mladenović
- Department of Built Environment, School of Engineering, Aalto University, Espoo, Finland.
| |
Collapse
|
7
|
Dhar P, Jones J. Electric scooter-related oral and maxillofacial injuries in Oxfordshire. Br J Oral Maxillofac Surg 2024; 62:826-830. [PMID: 39261156 DOI: 10.1016/j.bjoms.2024.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/07/2024] [Accepted: 07/26/2024] [Indexed: 09/13/2024]
Abstract
Electric scooters (e-scooters) are becoming increasingly popular amongst the public. Oxfordshire is included as part of the government led e-scooter trial. This study was designed to evaluate maxillofacial injuries occurring following e-scooter accidents. A single-centre retrospective study was conducted from October 2022 to September 2023 reviewing all e-scooter-related maxillofacial injuries which presented to the John Radcliffe Hospital in Oxford. During the study period, forty-nine patients (mean [range] age 28 [13-48] years; 32 [65.3%] male) suffered maxillofacial injuries from riding an e-scooter. Twenty patients (40.8%) were under the influence of alcohol and no individual was recorded to have worn a helmet at the time the injury occurred. Ten patients (20.4%) suffered a facial fracture (two mandibular fractures, three zygomatic-orbital fractures, one nasal fracture, and four patients with multiple fractures involving the sphenoid, zygomatic-orbital, and maxillary sinus). Four (40%) of these facial fractures required surgical management. This included one patient with an orbital floor fracture and an associated inferior rectus entrapment, which is a surgical emergency. Thirty-three patients (67.3%) sustained facial lacerations and nine patients (18.4%) sustained dental trauma. Maxillofacial injuries occurring from e-scooter injuries are significant and pose a notable risk to safety. Our study highlights poor compliance and emphasises the need to improve safety through public education, focussing on sobriety. Considerations should be given to speed limitations, safety clothing, e-scooter training, and whether helmets should be mandatory. The Oxfordshire trial is due to end in May 2026 and our results can inform and influence future legislation.
Collapse
Affiliation(s)
- Priya Dhar
- Department of Oral and Maxillofacial Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Headley Way, Headington, Oxford OX3 9DU, United Kingdom.
| | - Jon Jones
- Department of Oral and Maxillofacial Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Headley Way, Headington, Oxford OX3 9DU, United Kingdom.
| |
Collapse
|
8
|
Bareikis K, Gustaitiene G, Kozenevskyte E, Deltuva VP, Tamasauskas A. Electric scooter - related CT - positive brain injuries: a five - year single - centre experience overview. Neurosurg Rev 2024; 47:597. [PMID: 39261322 DOI: 10.1007/s10143-024-02842-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 08/29/2024] [Accepted: 09/07/2024] [Indexed: 09/13/2024]
Abstract
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).
Collapse
Affiliation(s)
- Karolis Bareikis
- Department of Neurosurgery, Hospital of Lithuanian University of Health Sciences, Kaunas Clinics, Kaunas, Lithuania.
| | - Gabriele Gustaitiene
- Department of Neurosurgery, Hospital of Lithuanian University of Health Sciences, Kaunas Clinics, Kaunas, Lithuania
| | - Estela Kozenevskyte
- Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vytenis Pranas Deltuva
- Department of Neurosurgery, Hospital of Lithuanian University of Health Sciences, Kaunas Clinics, Kaunas, Lithuania
- Institute of Neuroscience, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Arimantas Tamasauskas
- Department of Neurosurgery, Hospital of Lithuanian University of Health Sciences, Kaunas Clinics, Kaunas, Lithuania
- Institute of Neuroscience, Lithuanian University of Health Sciences, Kaunas, Lithuania
| |
Collapse
|
9
|
Salzano G, Maffia F, Vaira LA, Fusco R, Albanese M, Crimi S, Cucurullo M, Maglitto F, Maugeri C, Petrocelli M, Pitino F, Priore P, Roccia F, Tel A, Baietti AM, Bianchi A, Biglioli F, Copelli C, De Riu G, Nocini PF, Ramieri G, Robiony M, Valentini V, Califano L. The Impact of Standing Electric Scooters on Maxillofacial Fractures: An Italian Multi-Centric Epidemiological Study. J Clin Med 2024; 13:5195. [PMID: 39274410 PMCID: PMC11395837 DOI: 10.3390/jcm13175195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Revised: 08/28/2024] [Accepted: 08/30/2024] [Indexed: 09/16/2024] Open
Abstract
Objectives: This study aimed to determine the impact of standing electric scooters on maxillofacial on the Italian territory. Methods: The authors analyzed the epidemiology of the injuries to define electric mobility's impact on maxillofacial surgery practice. For this retrospective cohort study, data were collected by unifying the standing e-scooter-related fractures database from 10 Italian maxillofacial surgery departments. The reference period considered was from January 2020 to December 2023. The main data considered included age, gender, type of access, time slot of admission, type of admission, alcohol level, helmet use, dynamics of the accident, and area of the fracture. Results: A total of 79 patients were enrolled. The average age of the participants was approximately 31 years. The blood alcohol level was found to be above the Italian norm in 15 cases (19%). Only one patient wore a helmet. The most affected facial third was the middle one with 36 cases (45.5%), followed by the lower one (31, 39.3%). The most recurrent patterns were fractures of the orbito-malar-zygomatic complex (15, 19%), followed by multifocal (bifocal, trifocal) fractures of the mandible (14, 17.5%). Conclusions: This study demonstrated how maxillofacial fractures related to the use of electric scooters are associated with complex patterns, associated with a high rate of post-surgical aftermaths.
Collapse
Affiliation(s)
- Giovanni Salzano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80138 Naples, Italy
| | - Francesco Maffia
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80138 Naples, Italy
- PhD Program of the Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Roberta Fusco
- Oncology Medical and Research Development Division, Igea SpA, 80013 Naples, Italy
| | - Massimo Albanese
- Department of Oral and Maxillofacial Surgery, University of Verona, 37129 Verona, Italy
| | - Salvatore Crimi
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Marco Cucurullo
- Operative Unit of Maxillo-Facial Surgery, Head and Neck Department, San Paolo Hospital of Milan, 20122 Milan, Italy
| | - Fabio Maglitto
- Maxillo-Facial Surgery Unit, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Claudia Maugeri
- Department of Surgical Sciences, Division of Maxillofacial Surgery, Città della Salute e della Scienza Hospital, University of Turin, 10126 Turin, Italy
| | - Marzia Petrocelli
- Oral and Maxillo-Facial Unit, AUSL Bologna Bellaria-Maggiore Hospital, 40133 Bologna, Italy
| | - Francesca Pitino
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Paolo Priore
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Fabio Roccia
- Department of Surgical Sciences, Division of Maxillofacial Surgery, Città della Salute e della Scienza Hospital, University of Turin, 10126 Turin, Italy
| | - Alessandro Tel
- Head-Neck and NeuroScience Department, Clinic of Maxillofacial Surgery, University Hospital of Udine, 33100 Udine, Italy
| | - Anna Maria Baietti
- Oral and Maxillo-Facial Unit, AUSL Bologna Bellaria-Maggiore Hospital, 40133 Bologna, Italy
| | - Alberto Bianchi
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Federico Biglioli
- Operative Unit of Maxillo-Facial Surgery, Head and Neck Department, San Paolo Hospital of Milan, 20122 Milan, Italy
| | - Chiara Copelli
- Maxillo-Facial Surgery Unit, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Pier Francesco Nocini
- Department of Oral and Maxillofacial Surgery, University of Verona, 37129 Verona, Italy
| | - Guglielmo Ramieri
- Department of Surgical Sciences, Division of Maxillofacial Surgery, Città della Salute e della Scienza Hospital, University of Turin, 10126 Turin, Italy
| | - Massimo Robiony
- Head-Neck and NeuroScience Department, Clinic of Maxillofacial Surgery, University Hospital of Udine, 33100 Udine, Italy
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80138 Naples, Italy
| |
Collapse
|
10
|
Bhaskar B, Alumbaugh J, Zhang Z, Dillon J, Burke A. A Comparison of Maxillofacial and Head Injuries Following Electric Scooter and Bicycle Accidents. J Oral Maxillofac Surg 2024; 82:953-960.e4. [PMID: 38583488 DOI: 10.1016/j.joms.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/07/2024] [Accepted: 03/12/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND The prevalence of maxillofacial and head injuries associated with electric scooters (e-scooter, ES) has risen in concordance with its popularity. PURPOSE The purpose of this study was to compare maxillofacial and head injury location, type, and severity related to ES and bicycle accidents and to identify factors contributing to injury severity. STUDY DESIGN, SETTING, SAMPLE The authors implemented a multicenter retrospective cohort study in Seattle, Washington, and enrolled a sample of ES riders and bicyclists who sustained maxillofacial injuries between September 2020 and September 2022. The exclusion criteria included nonmotorized scooters, motorized bicycles, injuries with other operators, or vehicles, and pre-evaluation deaths. PREDICTOR VARIABLE The predictor variable was vehicle type, bicycle or ES. OUTCOME VARIABLES The outcome variables included maxillofacial injury location, distinguished by horizontal facial thirds and injury type, defined as hard or soft tissue. Associated head injury types were also reported as hard (calvaria) or soft (scalp) tissue injuries. The severity of these injuries was quantified using both the injury severity score and the face and head abbreviated injury scale. COVARIATES Demographic, injury, and treatment-related variables were collected. ANALYSES Bivariate, multivariate, and regression statistics were computed. Statistical significance was P < .05. RESULTS The final sample was composed of 205 total subjects, of which 52 (25.4%) were in the ES group and 153 (74.6%) in the bicycle group. Isolated midface injuries were the most common hard tissue location in the ES (15.4%) and bicycle (29.4%) groups. The most common soft tissue injury location included the upper face and midface in the ES group (19.2%) and the midface in the bicycle group (22.9%). Both hard and soft tissue head injuries were more prevalent in the ES group (P < .0002 and P < .0001). Moreover, intracranial injuries were seen in 36.5% of ES subjects compared to 9.8% bicycle subjects (P < .0001). Between the two groups there was no difference in maxillofacial injury severity, but head injuries were more severe in the ES group (P < .0002). Using regression analysis, drug use was found to have a significant impact on the mean injury severity score (P < .002) and helmet use did not have significant impact on face or head injury severity. CONCLUSION Maxillofacial injury location, type, and severity are comparable among ES and bicycles. However, ES riders are at greater risk of severe head injuries compared to bicycles, and riding while intoxicated has the greatest effect on injury severity.
Collapse
Affiliation(s)
- Brian Bhaskar
- Resident, Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA
| | - Joshua Alumbaugh
- Resident, Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA
| | - Zhehao Zhang
- PhD Candidate, Department of Statistics, University of Washington, Seattle, WA
| | - Jasjit Dillon
- Professor and Program Director, Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA
| | - Andrea Burke
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA.
| |
Collapse
|
11
|
Arikan Öztürk E, Karaçor F, Bayirtepe H. The characteristics of e-scooter accidents reported by police in Türkiye. TRAFFIC INJURY PREVENTION 2024; 25:1089-1097. [PMID: 39012933 DOI: 10.1080/15389588.2024.2363478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 05/25/2024] [Accepted: 05/30/2024] [Indexed: 07/18/2024]
Abstract
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.
Collapse
Affiliation(s)
- Ebru Arikan Öztürk
- Environmental and Technical Research of Accidents, Gazi University, Ankara, Türkiye
| | - Fatih Karaçor
- Department of Civil Engineering, Gazi University, Ankara, Türkiye
| | - Hikmet Bayirtepe
- Department of Civil Engineering, Gazi University, Ankara, Türkiye
| |
Collapse
|
12
|
Fernandez AN, Li KD, Patel HV, Allen IE, Ghaffar U, Hakam N, Breyer BN. Injuries With Electric vs Conventional Scooters and Bicycles. JAMA Netw Open 2024; 7:e2424131. [PMID: 39042404 PMCID: PMC11267411 DOI: 10.1001/jamanetworkopen.2024.24131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/23/2024] [Indexed: 07/24/2024] Open
Abstract
Importance Micromobility, the use of small vehicles (primarily scooters and bicycles), has become a standard transportation method in the US. Despite broad adoption of electric micromobility vehicles, there is a paucity of data regarding the injury profiles of these vehicles, particularly in the US. Objective To characterize micromobility injury trends in the US, identify demographic characteristic differences in users of electric and conventional vehicles, and identify factors associated with hospitalization. Design, Setting, and Participants This cross-sectional study queried the National Electronic Injury Surveillance System, a comprehensive database that collates injury data associated with consumer products from emergency departments across the US to provide national estimates, from calendar year 2017 to 2022. Data on micromobility vehicle injuries (bicycles, scooters, electric bicycles [e-bicycles], and electric scooters [e-scooters]) were obtained. Main Outcomes and Measures Trends in injury and hospitalization counts, injury characteristics, and factors associated with hospitalization. Results From 2017 to 2022, the US recorded 2 499 843 bicycle (95% CI, 1 948 539-3 051 147), 304 783 scooter (95% CI, 232 466-377 099), 45 586 e-bicycle (95% CI, 17 684-73 488), and 189 517 e-scooter (95% CI, 126 101-252 932) injuries. The median age of the riders was 28 (IQR, 12-51) years; 72% were male, 1.5% Asian, 13% Black, 12% Hispanic, and 49% White. Annual e-bicycle and e-scooter injuries increased from 751 (95% CI, 0-1586) to 23 493 (95% CI, 11 043-35 944) and injuries increased from 8566 (95% CI, 5522-11 611) to 56 847 (95% CI, 39 673-74 022). Compared with conventional vehicles, electric vehicle accidents involved older individuals (median age, 31 vs 27 years; P < .001) and a higher proportion of Black riders (25% vs 12%; P < .001). Helmet use was less in electric vehicle incidents compared with conventional vehicles (43% vs 52%; P = .02), and injuries were more common in urban settings (83% vs 71%; P = .008). Age-adjusted odds of hospitalization among all Black individuals compared with White individuals was 0.76 (95% CI, 0.59-0.98; P = .04). Conclusions and Relevance In this cross-sectional study of micromobility vehicles, an increased number of injuries and hospitalizations was observed with electric vehicles compared with conventional vehicles from 2017 to 2022. These findings suggest the need for change in educational policies, infrastructure, and law to recenter on safety with the use of micromobility vehicles.
Collapse
Affiliation(s)
| | - Kevin D. Li
- Department of Urology, University of California, San Francisco
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Hiren V. Patel
- Department of Urology, University of California, San Francisco
| | - Isabel Elaine Allen
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Umar Ghaffar
- Department of Urology, University of California, San Francisco
| | - Nizar Hakam
- Department of Urology, University of California, San Francisco
| | - Benjamin N. Breyer
- Department of Urology, University of California, San Francisco
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| |
Collapse
|
13
|
Spota A, Granieri S, Ferrario L, Zamburlini B, Frassini S, Reitano E, Cioffi SP, Altomare M, Bini R, Virdis F, Chiara O, Cimbanassi S. Injury Patterns of Electric-Scooter Related Trauma: A Systematic Review With Proportion Meta-Analysis. Am Surg 2024; 90:1702-1713. [PMID: 38532248 DOI: 10.1177/00031348241241682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Electric scooter (ES)-related injuries are increasing but poorly described. Clinicians need more information to be prepared for these patients. We supposed two prevalent patterns of patients: mildly injured (predominant upper-limb injuries) and severely injured (predominant head trauma). This study aims to understand the frequency of ES-related injuries and patients' characteristics despite the heterogeneity of data currently available. A systematic review with a proportion meta-analysis was conducted on studies with a multidisciplinary description of ES-related injuries in adult patients (PROSPERO-ID: CRD42022341241). Articles from inception to April 2023 were identified in MEDLINE, Embase, and Cochrane's databases. The risk of bias was evaluated using ROBINS-I. Twenty-five observational studies with 5387 patients were included in the meta-analysis, depending on reported data. Upper-limb (31.8%) and head (19.5%) injuries are the most frequent (25/25 studies included). When injured while riding, 19.5% of patients are intoxicated with drugs/alcohol, and only 3.9% use a helmet, increasing the possibility of severe injuries. About 80% of patients are victims of spontaneous falls. Half of the patients self-present to the ED, and 69.4% of cases are discharged directly from the ED. Studies' limitations include an overall moderate risk of bias and high heterogeneity. Electric scooter-related accidents are commonly associated with upper-limb injuries but often involve the head. Spontaneous falls are the most common mechanism of injury, probably related to frequent substance abuse and helmet misuse. This hot topic is not adequately investigated due to a lack of data. A prospective registry could fill this gap.
Collapse
Affiliation(s)
- Andrea Spota
- Acute care surgery and trauma, ASST GOM Niguarda, Milan, Italy
- Tissue Bank and Therapy, ASST GOM Niguarda, Milan, Italy
| | - Stefano Granieri
- General Surgery Unit, ASST-Brianza, Vimercate Hospital, Vimercate, Italy
| | - Luca Ferrario
- General Surgery Department, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milano, Italy
- Department of Biomedical and Clinical Sciences "Luigi Sacco," Università Degli Studi di Milano, Milano, Italy
| | | | - Simone Frassini
- Unit of General Surgery I, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
- General Surgery Residency Program, University of Pavia, Pavia, Italy
| | - Elisa Reitano
- Department of General Surgery, Nouvel Hôpital Civil, CHRU-Strasbourg, Strasbourg, France
| | - Stefano Pb Cioffi
- Acute care surgery and trauma, ASST GOM Niguarda, Milan, Italy
- Department of Surgical Sciences, University of Rome Sapienza, Roma, Italy
| | - Michele Altomare
- Acute care surgery and trauma, ASST GOM Niguarda, Milan, Italy
- Department of Surgical Sciences, University of Rome Sapienza, Roma, Italy
| | - Roberto Bini
- Acute care surgery and trauma, ASST GOM Niguarda, Milan, Italy
| | | | - Osvaldo Chiara
- Acute care surgery and trauma, ASST GOM Niguarda, Milan, Italy
- Department of Pathophysiology and Transplantation, State University of Milan, Milano, Italy
| | - Stefania Cimbanassi
- Acute care surgery and trauma, ASST GOM Niguarda, Milan, Italy
- Department of Pathophysiology and Transplantation, State University of Milan, Milano, Italy
| |
Collapse
|
14
|
Hirsch S, Wang T, Mann S. Impact of modern recreational conveyances on rates of pediatric craniofacial fractures. Laryngoscope Investig Otolaryngol 2024; 9:e1269. [PMID: 38887704 PMCID: PMC11181127 DOI: 10.1002/lio2.1269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/17/2024] [Accepted: 05/08/2024] [Indexed: 06/20/2024] Open
Abstract
Objective Trauma remains the leading cause of death for children over a year old. Motorized recreational conveyances (RCs) adds another potential cause of pediatric trauma. This study aims to determine the impact of adding electric motors to RCs on the severity and frequency of pediatric injuries and craniofacial fractures. Methods Pediatric trauma information was obtained from the National Electronic Injury Surveillance System (NEISS) database between 2012 and 2021. Demographics, injury cause, diagnoses, and incident narrative were collected. Bivariate and multivariate regression analyses were used to determine injury factors associated with serious injuries. Results One million five hundred ninety-six thousand five hundred fifty-nine encounters were examined; 113,905 (7.1%) were related to pediatric RCs and 5354 (5.4%) of those involved RCs with electric motors. 14.3% of injuries were related to scooters, 18.6% to skateboards, 54.2% to bicycles, and 12.9% to other RCs. There were significant differences in age, sex, race, helmet use, serious injuries, and craniofacial fractures between RC modalities. RC users were more likely to develop facial fractures (OR 2.12; 95%CI 2.01, 2.23; p < .001) and be involved in serious injuries (OR 1.42; 95%CI 1.38, 1.46; p < .001). Compared to their self-propelled counterparts, motorized scooters (OR 2.24; 95%CI 1.86, 2.69; p < .001) but not motorized skateboards (OR 1.01; 95%CI 0.88, 1.17; p = 0.88) were more likely to cause serious injuries. Helmet use was associated with fewer serious injuries (OR 0.5; 95%CI 0.46, 0.54; p < .001), facial fractures (OR 0.48; 95%CI 0.41, 0.55; p < .001), and skull fractures (OR 0.13; 95%CI 0.09, 0.17; p < .001). Conclusions The addition of electric motors to RCs significantly increases the risk of pediatric craniofacial fractures and serious injuries. Level of Evidence 3.
Collapse
Affiliation(s)
- Scott Hirsch
- Department of Otolaryngology—Head and Neck SurgeryUniversity of ColoradoAuroraColoradoUSA
| | - Tammy Wang
- Department of Otolaryngology—Head and Neck SurgeryUniversity of ColoradoAuroraColoradoUSA
- Department of Surgery and TraumaDenver Health Medical CenterDenverColoradoUSA
| | - Scott Mann
- Department of Otolaryngology—Head and Neck SurgeryUniversity of ColoradoAuroraColoradoUSA
- Department of Surgery and TraumaDenver Health Medical CenterDenverColoradoUSA
| |
Collapse
|
15
|
Sharpe J, Bakaes Y, Gauthier C, Bidwell R, Hurley DM, Murr K. The role of public policy in reducing moped and scooter injuries in South Carolina. Injury 2024; 55:111411. [PMID: 38359714 DOI: 10.1016/j.injury.2024.111411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/21/2024] [Accepted: 01/27/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Mopeds and electric scooters have grown in popularity in recent years. A South Carolina (SC) law was passed on November 19, 2018, aimed to regulate mopeds and scooters. This study aims to evaluate whether this SC law was associated with a decrease in the moped injury rate in a Level 1 Trauma Center. METHODS A retrospective review of trauma registry data was used to identify a cohort of patients 14 years and older who came to a Level 1 trauma center for a moped/scooter accident between January 2014 - December 2022. The proportion of moped injuries before and after the passing of the law was calculated. The chi-square test and Wilcoxon Rank Sum test were used to compare differences in proportions for categorical factors and continuous factors, respectively. RESULTS A total of 350 moped injury cases were identified. There was a significant decrease in the moped injury rate after the passing of the 2018 SC law (0.9 % vs 1.8 %, p<0.001). Additionally, those treated post-law implementation were significantly older (47.4 vs 43.2 years, p = 0.013) and more likely to be male (95.5 % vs 87.9 %, p = 0.025) than those treated pre-law. Patients treated post-law were significantly more likely to be uninsured (45.1 % vs 42.7 %, p = 0.009) and less likely to have commercial (16.2 % vs 20.1 %, p = 0.009), or government (29.7 % vs 35.6 %, p = 0.009) health insurance compared to those treated pre-law. There was no significant difference between the two groups in Glascow Coma Scale, Injury severity score, Trauma Injury Severity Score, or rate of fatalities. CONCLUSION After the implementation of a SC law, we found that the local proportion of injuries due to moped and scooter accidents was significantly lower than pre-law proportions. These findings suggest that public policies aimed at increasing regulations for mopeds may decrease the rate of injury, but not severity, from moped use.
Collapse
Affiliation(s)
- John Sharpe
- Department of Orthopedic Surgery, Prisma Health - Midlands, 2 Medical Park Rd Suite 404, Columbia, SC 29203, United States
| | - Yianni Bakaes
- Department of Orthopedic Surgery, Prisma Health - Midlands, 2 Medical Park Rd Suite 404, Columbia, SC 29203, United States
| | - Chase Gauthier
- Department of Orthopedic Surgery, Prisma Health - Midlands, 2 Medical Park Rd Suite 404, Columbia, SC 29203, United States.
| | - Richard Bidwell
- Department of Orthopedic Surgery, Prisma Health - Midlands, 2 Medical Park Rd Suite 404, Columbia, SC 29203, United States
| | - Deborah M Hurley
- Data Support Core, Prisma Health - Midlands, 9 Medical Park Rd, Suite 400, Columbia, SC 29203, United States
| | - Kevin Murr
- Department of Orthopedic Surgery, Prisma Health - Midlands, 2 Medical Park Rd Suite 404, Columbia, SC 29203, United States
| |
Collapse
|
16
|
Cho NY, Kim S, Tran Z, Hadaya J, Ali K, Kronen E, Burruss S, Benharash P. National Trends and Clinical Outcomes after Scooter Injury in the US: 2016 to 2020. J Am Coll Surg 2024; 238:254-260. [PMID: 38193571 DOI: 10.1097/xcs.0000000000000918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
BACKGROUND In recent years, the adoption of electric scooters has been accompanied by a surge of scooter-related injuries in the US, raising concerns for their severity and associated healthcare costs. This study aimed to assess temporal trends and outcomes of scooter-related hospital admissions compared with bicycle-related hospitalizations. STUDY DESIGN This was a retrospective cohort study using the 2016 to 2020 National Inpatient Sample for patients younger than 65 years who were hospitalized after bicycle- and scooter-related injuries. The Trauma Mortality Prediction Model was used to quantify injury severity. The primary outcomes of interest were temporal trends of micromobility injuries. In-hospital mortality, rates of long bone fracture, traumatic brain injury, paralysis, length of stay, hospitalization costs, and nonhome discharge were secondarily assessed. RESULTS Among 92,815 patients included in the study, 6,125 (6.6%) had scooter-related injuries. Compared with patients with bicycle-related injuries, patients with scooter-related injuries were more commonly younger than 18 years (26.7% vs 16.4%, p < 0.001) and frequently underwent major operations (55.8% vs 48.1%, p < 0.001). After risk adjustment, scooter-related injuries were associated with greater risks of long bone fracture (adjusted odds ratio 1.40, 95% CI 1.15 to 1.70) and paralysis (adjusted odds ratio 2.06, 95% CI 1.16 to 3.69) compared with bicycle-related injuries. Additionally, patients with bicycle- or scooter-related injuries had comparable index hospitalization durations of stay and costs. CONCLUSIONS The prevalence and severity of scooter-related injuries have significantly increased in the US, thereby attributing to a substantial cost burden on the healthcare system. Multidisciplinary efforts to inform safety policies and enact targeted interventions are warranted to reduce scooter-related injuries.
Collapse
Affiliation(s)
- Nam Yong Cho
- From the Cardiovascular Outcomes Research Laboratories (CORELAB) (Cho, Kim, Tran, Hadaya, Ali, Kronen, Benharash), David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Shineui Kim
- From the Cardiovascular Outcomes Research Laboratories (CORELAB) (Cho, Kim, Tran, Hadaya, Ali, Kronen, Benharash), David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Zachary Tran
- From the Cardiovascular Outcomes Research Laboratories (CORELAB) (Cho, Kim, Tran, Hadaya, Ali, Kronen, Benharash), David Geffen School of Medicine, University of California, Los Angeles, CA
- Division of Acute Care Surgery, Department of Surgery, Loma Linda University Health, Loma Linda, CA (Tran, Burruss)
| | - Joseph Hadaya
- From the Cardiovascular Outcomes Research Laboratories (CORELAB) (Cho, Kim, Tran, Hadaya, Ali, Kronen, Benharash), David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Konmal Ali
- From the Cardiovascular Outcomes Research Laboratories (CORELAB) (Cho, Kim, Tran, Hadaya, Ali, Kronen, Benharash), David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Elsa Kronen
- From the Cardiovascular Outcomes Research Laboratories (CORELAB) (Cho, Kim, Tran, Hadaya, Ali, Kronen, Benharash), David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Sigrid Burruss
- From the Cardiovascular Outcomes Research Laboratories (CORELAB) (Cho, Kim, Tran, Hadaya, Ali, Kronen, Benharash), David Geffen School of Medicine, University of California, Los Angeles, CA
- Division of Acute Care Surgery, Department of Surgery, Loma Linda University Health, Loma Linda, CA (Tran, Burruss)
| | - Peyman Benharash
- Division of Cardiac Surgery, Department of Surgery (Benharash), David Geffen School of Medicine, University of California, Los Angeles, CA
| |
Collapse
|
17
|
Lee SJ, Kim JH. A retrospective comparative study of maxillofacial injury patterns caused by electric scooters and bicycles. Dent Traumatol 2024; 40:76-83. [PMID: 37612882 DOI: 10.1111/edt.12878] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/04/2023] [Accepted: 07/18/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND/AIM The emergence of shared stand-up electric scooters has led to an increase in their usage and, subsequently, an increase in the incidence of maxillofacial trauma. This study aimed to investigate the trauma pattern associated with the use of stand-up electric scooters compared with that related to the use of bicycles, which was a popular mode of personal mobility before the emergence of stand-up electric scooters. MATERIALS AND METHODS This study investigated the medical records of patients who visited Wonju Christian Hospital for maxillofacial trauma due to the use of stand-up electric scooter and bicycles between November 1, 2017 and October 31, 2022. Maxillofacial trauma was analyzed based on medical records, including those in the evaluation results of teeth, maxillofacial bones, and soft tissues. RESULTS Crown fractures and tooth avulsions were observed more frequently with the use of stand-up electric scooters than with the use of bicycles. In contrast, crown-root fractures, tooth subluxation, and extrusive luxation were more commonly observed in bicycle riders. Additionally, the proportion of root fractures was similar between the two groups. However, no vertical root fractures were observed in patients who rode bicycles. The maxillofacial bone fracture rates between the two groups were similar, although the fracture patterns were different. CONCLUSION The number of patients using stand-up electric scooters is increasing, and they are likely to have a worse prognosis compared with those using existing personal mobility devices.
Collapse
Affiliation(s)
- Seong Joon Lee
- Department of Pediatric Dentistry, Wonju Severance Christian Hospital, Yonsei University, Wonju, South Korea
| | - Ji Hun Kim
- Department of Pediatric Dentistry, Wonju Severance Christian Hospital, Yonsei University, Wonju, South Korea
- Department of Dentistry, Wonju College of Medicine, Yonsei University, Wonju, South Korea
| |
Collapse
|
18
|
Azab M, Gamboa N, Nadel J, Cutler C, Lucke-Wold B, Karsy M. In Reply to the Letter to Editor Regarding "Case Series and Systematic Review of Electronic Scooter Crashes and Severe Traumatic Brain Injury". World Neurosurg 2023; 173:303. [PMID: 37189322 DOI: 10.1016/j.wneu.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 05/17/2023]
Affiliation(s)
- Mohammad Azab
- Department of Biological Sciences, Boise State University, Boise, Idaho, USA
| | - Nicholas Gamboa
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
| | - Jeffrey Nadel
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
| | - Christopher Cutler
- Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Michael Karsy
- Global Neurosciences Institute, Philadelphia, Pennsylvania, USA; Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
| |
Collapse
|
19
|
Armocida D, Santoro A, Frati A. Letter to the Editor Regarding "Case Series and Systematic Review of Electronic Scooter Crashes and Severe Traumatic Brain Injury". World Neurosurg 2023; 173:301-302. [PMID: 37189321 DOI: 10.1016/j.wneu.2023.02.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 05/17/2023]
Affiliation(s)
- Daniele Armocida
- Human Neurosciences Department, Neurosurgery Division "Sapienza" University, AOU Policlinico Umberto I, Rome, Italy; IRCCS "Neuromed" Pozzilli (IS), Molise, Italy.
| | - Antonio Santoro
- Human Neurosciences Department, Neurosurgery Division "Sapienza" University, AOU Policlinico Umberto I, Rome, Italy
| | | |
Collapse
|
20
|
Andersson O, Djärv T. Electric scooter accidents leading to emergency department visits: influence of alcohol and outcomes in Stockholm, Sweden. Sci Rep 2023; 13:5946. [PMID: 37045881 PMCID: PMC10097862 DOI: 10.1038/s41598-023-32857-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Olle Andersson
- Department of Emergency Medicine, Karolinska University Hospital, Solna, Sweden
| | - Therese Djärv
- Department of Emergency Medicine, Karolinska University Hospital, Solna, Sweden.
- Department of Medicine Solna, Karolinska Institutet, 171 76, Stockholm, Sweden.
| |
Collapse
|