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

Analysis of Injuries Caused by Electric Scooters Admitted to the Emergency Department: A Prospective Observational Study

OBJECTIVE

This study aims to investigate and analyze the patterns, types, and epidemiology of E-scooter-related injuries presenting to the emergency department as well as to determine possible factors that may affect the severity of injury.

METHODS

This is a prospective observational study conducted in an inner-city tertiary education and research hospital with 290,000 annual emergency admissions in tax in Istanbul, Turkiye. The study period was defined as 01.02.2022-01.02.2023. Patients presenting to the emergency department with an electrical scooter injury were included in the study.

RESULTS

A total of 137 electrical scooter cases were included in the study. Our results revealed a male predominance (73.7%), with the highest incidence observed in the 17-25 age group. Most accidents involved the electrical scooter rider (92.7%), occurring predominantly as falls (75.2%) and commonly on main roads (70.8%). Accidents were more prevalent during weekdays and between 07:00 and 18:00, aligning with commuting hours. In terms of severity, 83.9% were classified as minor (ISS < 9), 9.5% as moderate (ISS = 9-15), 2.9% as severe (ISS = 16-25), and 3.6% as critical (ISS > 25). Traumatic brain injuries were observed in 12 patients. 4.4% had concussion, and 4.4% intracranial hemorrhage. One of the patients with subarachnoid hemorrhage died in an intensive care unit.

CONCLUSION

Although minor injuries are more common, the fact that we have a deceased case and patients with potentially fatal traumatic brain injuries suggests accidents involving electrical scooters should be carefully examined and preventive measures and regulations should be implemented by the governments.

Head and neck injuries from personal motorised vehicles in the United States

BACKGROUND

The use of personal electric vehicles in the United States has increased head and neck injuries. This study analyses the types, frequencies, demographics and management of these injuries across motorised vehicles.

METHODS

This study uses 2020-2023 data from the National Electronic Injury Surveillance System to analyse injuries from various powered vehicles, incorporating diagnostic, event-related and demographic factors. In addition, the study evaluates non-powered skateboard-related injuries, which provided a comparable baseline for motorised vehicle injuries.

RESULTS

Our analysis included 3721 head and neck injuries: 1359 from scooters, 1743 from skateboards and 619 from hoverboards. Males sustained most injuries, accounting for 64% of scooter accidents, 74% of skateboard accidents and 58% of hoverboard accidents. Hospitalisation was required in 10% of scooter accidents, 9.2% of skateboard accidents and 6.9% of hoverboard accidents. Males, alcohol use and drug use were associated with increased risk of hospitalisation (p=0.00002, p=0.00004 and p<0.00001, respectively). Internal injury (37%) and lacerations (24%) were the most common types of injury. In cases, wear helmets were worn involving helmets, there were no significant differences in hospitalisation rates.

DISCUSSION

These findings underscore the need for improved injury prevention strategies, including more effective helmet designs and infrastructure enhancements, to reduce the growing burden of micromobility vehicle-related head and neck injuries.

CONCLUSION

The rising incidence of head and neck injuries associated with personal mobility vehicles highlights the need for injury management and prevention strategies. Helmets may mitigate head and neck injuries associated with motorised scooters, skateboards and hoverboards.

Characteristics of e-scooter and bicycle injuries at a university hospital in a large German city - a one-year analysis

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.

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.

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).

New generation vehicles: the impact of electric scooter trauma on the severity of facial fractures assessed by FISS score. A multicentre study

With the increasing use of sustainable energy sources, the electric scooter has become a widely used vehicle. The aim of the study is to analyse the types of facial fracture related to road traffic accidents to outline the need for dedicated road rules. An observational, retrospective, multicentre study was carried out at the Maxillofacial Surgery Units of six Italian hospitals. Fifty patients (mean age was 34.76 years) from January 2020 to January 2024 were enrolled. The severity of trauma was evaluated by the Facial Injury Severity Scale (FISS) by Bagheri et al. Most of the accidents occurred during the day and the weekend in spring or summer; 24 drivers collided with infrastructures or pedestrians, while 26 involved other vehicles. A total of 33 vehicles were rented, and 17 were privately owned. A total of 43 subjects were not wearing helmets, five patients were drunk, and three patients took drugs. In order of frequency, the facial fractures involved: zygomatico-maxillary-orbital complex (ZMOC) (n = 16), mandibular condyle (n = 13), nasal bone (n = 11), orbit floor (n = 8), and mandibular body (n = 7). Fractures such as Le Fort I (n = 4), naso-orbito-ethmoidal NOE (n = 4) and mandibular ramus (n = 4) were less common. Other types of facial fracture were rare. Thirty patients reported multiple facial fractures. The vast majority of the cases showed a low severity grade FISS score. Fifteen patients suffered polytrauma. The mean hospitalisation time was 8.3 days. As accidents with electric scooters are increasing, it is important to characterise the most frequent facial fractures to improve patient management and encourage the introduction of new road rules.

A Comparison of Maxillofacial and Head Injuries Following Electric Scooter and Bicycle Accidents

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.

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.

Understanding nonuse of mandatory e-scooter helmets

OBJECTIVES

Head injuries resulting from e-scooter use have led to calls for helmet use to be promoted or mandatory. Helmet use is mandatory for e-scooters in Australia but observational studies have reported significant levels of nonuse, particularly by riders of shared e-scooters. The aim of this study is to understand whether nonuse in the mandatory context is a consistent behavior for an individual or is situationally-influenced, and what are the factors associated with nonuse.

METHODS

An online survey was completed between 2022 and 2023 by 360 adult e-scooter riders in Canberra, Australia. Riders were asked whether they had worn a helmet on their last ride and how often they had not worn a helmet when riding in the last 30 days. The survey also asked about rider characteristics (demographics, frequency of e-scooter and bicycle use, perceived risk of e-scooter use, e-scooter ownership, and risky behaviors while riding), trip duration and perceptions of the helmet requirement (knowledge of and support for the law).

RESULTS

Respondents were mostly male, young, highly educated, and full-time workers. Of the 29.1% of riders who reported riding without a helmet in the last 30 days, 24.4% had worn a helmet at least once during that period and 4.8% had consistently not worn a helmet. Younger age, shared e-scooter use and more frequent riding frequency (shared e-scooters only) were associated with helmet nonuse in the bivariate analyses but not in the logistic regression. Logistic regression showed that the independent predictors of helmet nonuse were the number of risky riding behaviors, lack of knowledge, and lack of support for the law.

CONCLUSIONS

Most nonuse of helmets in a mandatory context seems to be situational, rather than consistent. Many of the factors associated with nonuse of helmets for e-scooters are similar to those reported for bicycles. Nonuse of helmets appears to be one of a number of risky behaviors performed by riders, rather than being primarily an outcome that is specific to factors associated with helmets (e.g., concerns about hygiene, discomfort or availability).

Electric scooter-related orthopedic injuries: the experience of an Italian orthopedic center and literature review

Background

With the increasing prevalence of electric scooters, a concomitant increase in the number of specific injuries, emergency department (ED) admissions and hospital admissions have been reported.

Objectives

Analyze patient flow changes in the ED with a focus on e-scooter-related injuries through a case series and a comparison with the contemporary literature.

Data sources

A systematic literature review was performed on Medline/PubMed and Embase using terms related to the topic.Data collected from two-wheeled vehicle trauma patients at our Italian ED from May 1 to October 31, 2021, were analyzed for the case series.

Study eligibility criteria

Studies were included if they evaluated populations with an e-scooter-related injury referred to the ED with precise localization and nature of the injury reported.

Participants and interventions

Data collected from the literature studies and from our case series included overall ED patient numbers, patient demographics, injury mechanism, location of the injury, discharge diagnosis, and performance of surgery.

Study appraisal and synthesis methods

All studies were checked in order to establish the coherence with the purposes of this review. Data from the contemporary literature and from this case series were compared.

Results

During a 6-month period, 280 patients had e-scooter injuries, resulting in 292 traumas, including 123 fractures, primarily in the elbow. Surgical intervention was necessary for 28 patients. The review included nine papers, highlighting that injuries to the upper and lower extremities and head were frequent in e-scooter-related incidents. The upper extremities were the most common fracture location.

Limitations

The study is a retrospective, single-center study without a comparison group, focusing exclusively on orthopedic injuries.

Conclusions or implications of key findings

The prevalence of electric scooters, which offer an affordable and eco-friendly mode of transport, is steadily increasing. It is important to focus on injury risk mitigation through effective public health policies, thereby lowering costs to society.

Lessons learned? Increasing injury severity of electric-scooter accidents over a period of one year: a monocentric follow-up study at a level 1 trauma center

PURPOSE

After major COVID-19 lockdown measures were suspended in 2021, E-scooter mobility regrew rapidly. In the meantime, multiple studies were published on the potential risks for e-scooter drivers and the necessity for wearing protective equipment. But did the drivers learn their lessons?

METHODS

We observed data of E-scooter-related accidents admitted to the emergency department of a level 1 German trauma center in the year 2021 and compared the data with our previous report (July 2019-July 2020).

RESULTS

N = 97 E-scooter-related accidents were included, marking a 50% increase when compared to the previous observation. Most patients were young adults (28.18 ± 1.13 years) with a notable shift towards a male population (25 vs. 63, p = 0.007). While the injury pattern remained unchanged, injury severity, reflected by a significant increase in shock room treatments (p = 0.005), hospital admissions (p = 0.45), and ICU admissions (p = 0.028), increased. Lastly, we report a higher injury severity of patients driving under the influence of alcohol, expressed by significant differences in hospital admissions, shock room treatments, ICU admissions, intracerebral bleeding (p < 0.0001), and injuries requiring surgery (p = 0.0017).

CONCLUSION

The increase in injury severity and especially the substantial number of accidents due to driving under the influence of alcohol, are alarming for both trauma- and neurosurgeons. As the controversy surrounding the general use of E-scooters will continue, we urge representatives to intensify their efforts regarding prevention campaigns focusing on the potential dangers of E-scooters, especially when driving under the influence of alcohol.

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.

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.

Characteristics of Electric Scooter and Bicycle Injuries After Introduction of Electric Scooter Rentals in Oslo, Norway

Importance

When society introduces and accepts new transportation modes, it is important to map risks and benefits.

Objective

To compare electric scooter (e-scooter) and bicycle injuries.

Design, Setting, and Participants

This cohort study is based on prospectively collected data on Norwegian patients who sustained e-scooter or bicycle injuries and presented to an emergency department affiliated with Oslo University Hospital between January 1, 2019, and March 31, 2020.

Main Outcomes and Measures

e-Scooter and bicycle injuries were evaluated for associations with sex, age, time of injury, helmet use, intoxication, body region, and injury severity. Descriptive statistics are presented as mean (SD) or number with percentage, with significance set at P < .05 (2-tailed).

Results

During the study period, 3191 patients were included (850 e-scooter riders, 2341 bicyclists) with 3839 injuries recorded (997 e-scooter, 2842 bicycle). The mean (SD) age of those injured was 34 (17) years, 2026 riders (63.5%) were male, 1474 (46.2%) were helmeted at the time of injury, and 516 (16.2%) were intoxicated by alcohol or other drugs. The annual incidence of injuries was 120 per 100 000 inhabitants for e-scooters and 340 per 100 000 inhabitants for bicycles. Men were overrepresented in both groups (529 e-scooter riders [62.2%] and 1497 bicyclists [63.9%]). e-Scooter riders were younger than bicyclists (mean [SD] age, 31 [12] vs 35 [18] years). Most injured e-scooter riders were aged 20 to 40 years, whereas injured bicyclists had a broader age distribution. e-Scooter injuries commonly occurred on weekends (378 [46.6%]) and during evening (230 [32.3%]) or nighttime (242 [34.1%]) hours. Most bicycle injuries occurred during weekdays (1586 [69.7%]) and daytime (1762 [61.3%]). e-Scooter riders were more often intoxicated (336 [39.5%] vs 180 [7.7%]) and had a lower rate of helmet use (18 [2.1%] vs 1456 [62.2%]). During nighttime, 230 injured e-scooter riders (91.3%) and 86 bicyclists (69.4%) were intoxicated. e-Scooter riders had more head and neck (317 [31.7%] vs 636 [22.4%]) and lower-limb (285 [28.6%] vs 632 [22.2%]) injuries and fewer upper-limb (341 [34.2%] vs 1276 [44.9%]), thoracic (41 [4.1%] vs 195 [6.9%]), and abdominal, pelvic, and lumbar (13 [1.3%] vs 103 [3.6%]) injuries.

Conclusions and Relevance

In this cohort study, e-scooter riders were younger than bicyclists, did not use helmets, were more often intoxicated, and were more often injured during nighttime. The rate of intoxication among e-scooter riders injured at night was high. Preventive measures, including awareness campaigns, regulating e-scooter availability, improving infrastructure, and implementing stricter helmet and alcohol policies, may prove effective for reducing injuries.

E-scooters and the City – head to toe injuries

In the recent years electric scooters have become much more common. As the number of drivers increased, so did the number of accidents and injuries involving e-scooters. The most common are head and neck injuries, including open wounds of soft tissues, traumatic brain injuries (TBIs), fractures of the skull bones, and intracerebral hemorrhages (ICH). The second most frequent are injuries to both upper and lower limbs. Fractures of the spine and injuries to the chest and abdominal cavity are less common. Many injuries could be avoided by using helmets, not driving e-scooters under the influence of intoxicating substances, and systematizing the rules of using e- scooters among other road traffic users.