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Rashid J, Sritharan R, Wu S, McMillan K. E-scooter-related dental injuries: a two-year retrospective review. Br Dent J 2024:10.1038/s41415-024-7345-4. [PMID: 38693336 DOI: 10.1038/s41415-024-7345-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 05/03/2024]
Abstract
Introduction In June 2020, the United Kingdom (UK) published guidance on electric scooter (e-scooter) use to ease transport congestion and reduce pollution. This study aims to examine dental injuries sustained during the two years following initiation of the trial.Methods The research was conducted at a UK, Level 1, supra-regional major trauma centre. All eligible patient records were analysed to identify e-scooter-related dental injuries to the following regions: teeth, periodontium, alveolus, palate, tongue, floor of mouth, frenum, buccal mucosa and lips. To assess significant associations between recorded variables, a Pearson's chi-square test was utilised.Results Of the 32 patients who experienced a total of 71 dental injuries, 46.5% (n = 33) affected teeth, predominantly upper central incisors (n = 17). 'Lacerations' (n = 32) and 'lips' (n = 30) were the most common type and site of soft tissue injuries, respectively. Unprovoked falls by riders accounted for 53.1% (n = 17) of the injuries. There was an overall increase in e-scooter-related dental injuries throughout the two-year period.Conclusion E-scooters have introduced an additional source of dental trauma. It is imperative health care professionals can also identify signs of head and non-dental injuries when managing such patients. Further studies are warranted allowing for better informed and optimised dental public health interventions.
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Affiliation(s)
- Junaid Rashid
- Dental Core Trainee, Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2GW, UK.
| | - Rajeevan Sritharan
- Junior Specialist Dentist, Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2GW, UK
| | - Sophie Wu
- Dental Core Trainee, Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2GW, UK
| | - Kevin McMillan
- Consultant in Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2GW, UK
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Cevik J, Read D, Putland M, Fazio T, Gumm K, Varma A, Santos R, Ramakrishnan A. The impact of electric scooters in Melbourne: data from a major trauma service. ANZ J Surg 2024; 94:572-579. [PMID: 38087881 DOI: 10.1111/ans.18814] [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: 10/19/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 04/17/2024]
Abstract
BACKGROUND The proliferation of electric scooters globally has been associated with an increase in related injuries and consequent economic burden. This study aims to assess the injury patterns and the economic impact associated with electric scooter use in Melbourne, Australia. METHODS A retrospective cohort study was conducted using hospital and registry data from January 2022 to January 2023. Data collected included demographic details, alcohol and helmet use, injury type and severity, operative treatment provided, and direct medical costs. The economic impact (in AUD) of the patient's emergency presentation and hospital admission was calculated. RESULTS During the study period, 256 electric scooter related injuries were recorded, comprising 247 riders and nine pedestrians. The majority of patients were males (69%) with a median age of 29.5 (15-78). Alcohol use was reported by 34% and helmet use by 33%. Injuries most commonly affected the upper limb (53%) and head (50%), with abrasions (75%) and fractures (48%) being the most common type of injury sustained. The total hospital cost was $1 911 062, and the median cost was $1321.66 per patient (IQR: $479.37-$5096.65). CONCLUSION Electric scooter usage, as observed through patient presentations to the Royal Melbourne Hospital, is associated with a considerable number of injuries, primarily among young males, and an ensuing substantial economic burden. The findings underscore the urgent need for improved safety measures to minimize electric scooter-related injuries and their clinical and economic repercussions.
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Affiliation(s)
- Jevan Cevik
- Department of Plastic Surgery, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - David Read
- Trauma Service, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mark Putland
- Emergency Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Timothy Fazio
- Health Intelligence Unit, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kellie Gumm
- Trauma Service, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Amrita Varma
- Department of Plastic Surgery, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Roselyn Santos
- Trauma Service, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Anand Ramakrishnan
- Department of Plastic Surgery, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
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Rashid J, Wu S, Abdelrahman A, McMillan K. Maxillofacial trauma caused by e-scooters: a retrospective review prior to the extension of the UK scheme. Br J Oral Maxillofac Surg 2024; 62:157-163. [PMID: 38238115 DOI: 10.1016/j.bjoms.2023.11.008] [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: 07/05/2023] [Revised: 11/12/2023] [Accepted: 11/28/2023] [Indexed: 03/02/2024]
Abstract
The nationwide extension of the electric scooter (e-scooter) scheme, which began in 2020, aimed to alleviate public transport congestion, to reduce pollution and peak-time road traffic. This retrospective study evaluates the range of e-scooter-related maxillofacial trauma before the recent scheme extension and compares the findings with existing literature on this topic. The Queen Elizabeth Hospital Birmingham, United Kingdom (UK) operates as a Level 1 Regional Major Trauma Centre and serves a population of four million. All patient records between September 2021 to September 2022 were analysed to establish the types of e-scooter-related maxillofacial trauma sustained. A Pearson's chi-squared test was used to assess for significant associations between variables recorded. Falls accounted for the majority of injuries (44.3%), and soft tissue lacerations were the most common maxillofacial injury (38%). Statistically significant results were measured in the following variables: gender and intoxication status (p = 0.007), helmet status and injuries sustained in maxillofacial and non-maxillofacial regions (p = 0.043), mechanism of injury and injuries sustained in both the maxillofacial and non-maxillofacial regions (p = 0.045). E-scooters are an emerging concern within the UK. Further studies across the UK are required to assess the frequency of e-scooter-related injuries. Such data may prove useful in determining the government's decision on e-scooter use on UK roads.
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Affiliation(s)
- J Rashid
- Department of Oral & Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Birmingham B15 2GW, United Kingdom.
| | - S Wu
- Department of Oral & Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Birmingham B15 2GW, United Kingdom.
| | - A Abdelrahman
- Department of Oral & Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Birmingham B15 2GW, United Kingdom.
| | - K McMillan
- Department of Oral & Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Birmingham B15 2GW, United Kingdom.
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Goh EZ, Beech N, Johnson NR. E-Scooters and Craniofacial Trauma: A Systematic Review. Craniomaxillofac Trauma Reconstr 2023; 16:245-253. [PMID: 37975032 PMCID: PMC10638976 DOI: 10.1177/19433875221118790] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Study Design Systematic review. Objective Standing electric scooters (e-scooters) provide a cheap and environmentally friendly transport alternative, but also elicit substantial concern regarding their volume of associated injuries especially in the craniofacial region. This review aims to explore the demographics, risk factors, types of injury and surgical management of craniofacial trauma associated with e-scooters. Methods PubMed and Scopus databases were systematically searched. Inclusion criteria were clinical studies investigating craniofacial trauma associated with e-scooters. Exclusion criteria were duplicates; non-English publications; non-full-text publications; studies with insufficient data. Results Of the 73 articles identified, 10 eligible articles representing 539 patients were included. The mean age was 31.5 years. Most cases were male (63.7%). Common risk factors were alcohol/drug intoxication, absence of distal extremity injuries and lack of helmet use. The most common mechanism of injury was mechanical falls (72.4%). The most common facial fracture pattern was middle third fractures (58.3%). Surgical management was required for 43.3% of fractures. Other types of injuries reported were traumatic brain injuries (17.6%), soft tissue injuries (58.3%), dental injuries (32.9%) and ophthalmological injuries (20.6%). Conclusions The findings of this review suggest common presentations for craniofacial trauma associated with e-scooters. Robust longitudinal evaluations with standardised descriptions of types of injuries are required. Gaps in knowledge relate to surgical management, post-operative complications and associated risk factors.
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Affiliation(s)
- Elizabeth Z. Goh
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Nicholas Beech
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Nigel R. Johnson
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Oral and Maxillofacial Department, Princess Alexandra Hospital, Brisbane, QLD, Australia
- School of Dentistry, University of Queensland, Brisbane, QLD, Australia
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Sher T, Shah J, Holbrook EA, Thomas A, Wilson J. Electric Scooter Injuries in Tampa, Florida, Are Associated With High Rates of Head Injury, Hospital Admission, and Emergency Medical Service Transport and Low Rates of Helmet Use. Cureus 2023; 15:e39523. [PMID: 37366452 PMCID: PMC10290810 DOI: 10.7759/cureus.39523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 06/28/2023] Open
Abstract
Background Standing electric scooters (e-scooters) were introduced in Tampa, Florida, in 2019. We reviewed 292 e-scooter injury cases at the Tampa General Hospital Emergency Department (ED) to determine what insights we could gain. We sought to identify the characteristics of such presentations, including chief complaint (CC), patient age, day of the week, time of day, length of stay, disposition, acuity, and means of arrival to the ED. We were particularly interested in studying the rates of hospital admission, Emergency Medical Service (EMS) transport, emergent acuity presentations, and head injuries. We also sought to identify the prevalence of alcohol use prior to e-scooter accidents and its effect on the above factors. Methodology This was a retrospective chart review and was exempt from the University of South Florida's Institutional Review Board approval (STUDY004031). Data from routine clinical care in the Tampa General Hospital ED, a Level-1 Trauma Center ED in Tampa, Florida, from July 19, 2019, to May 30, 2022, were collected through an operational report within the business intelligence infrastructure of the hospital's electronic medical record system. Data from patients with scooter injury-related encounter codes were extracted to an electronic data capture form and deidentified. Narratives were reviewed to exclude uncertain cases (e.g., patients with moped, kick scooter, mobility scooter injuries, etc.) and to flag for alcohol endorsement, altered mental status, helmet usage, and head injuries that were not listed as the CC. CC, means of arrival, acuity, disposition, arrival/departure day of week, and arrival/departure hour were collected. Data analysis was completed using Microsoft Excel version 16.5 (Microsoft Corp., Redmond, WA, USA) and SPSS Statistics version 28.0 (IBM Corp., Armonk, NY, USA). Results A total of 292 of 442 collected cases remained after removing irrelevant flags. Overall, 30.8% (n = 90) of patients were between the ages of 21 and 30, and most patients presented on weekends and nights. Moreover, 40.8% (n = 119) suffered head injuries, 40.8% (n = 119) arrived via EMS, 31.5% (n = 92) were admitted to the hospital, and 18.8% (n = 55) were designated as emergent acuity. Apart from the admission rate, these rates were all higher among alcohol endorsers (39, 13.4%) than non-endorsers (253, 86.6%). Only 2.1% of patients endorsed helmet use. Conclusions We found higher rates of hospital admission and EMS transports in our ED than many previous studies in urban areas have reported. Our data suggest that alcohol use increases the risk of more serious e-scooter injuries, characterized by higher acuity, EMS transport rate, and head injuries among alcohol endorsers. These findings are highly relevant due to the rapidly growing e-scooter presence across the United States and may serve to inform hospitals and EMS systems regarding their role in injury management, as well as future policy regarding their safe use.
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Affiliation(s)
- Theo Sher
- Emergency Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Jay Shah
- Emergency Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | | | - Andrew Thomas
- Emergency Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
| | - Jason Wilson
- Emergency Medicine, University of South Florida Morsani College of Medicine, Tampa, USA
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Kleinertz H, Volk A, Dalos D, Rutkowski R, Frosch KH, Thiesen DM. Risk factors and injury patterns of e-scooter associated injuries in Germany. Sci Rep 2023; 13:706. [PMID: 36639664 PMCID: PMC9837749 DOI: 10.1038/s41598-022-25448-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 11/30/2022] [Indexed: 01/14/2023] Open
Abstract
Since the introduction of widely available e-scooter rentals in Hamburg, Germany in June of 2019, our emergency department has seen a sharp increase in the amount of e-scooter related injuries. Despite a rising number of studies certain aspects of e-scooter mobility remain unclear. This study examines the various aspects of e-scooter associated injuries with one of the largest cohorts to date. Electronic patient records of emergency department admissions were screened for e-scooter associated injuries between June 2019 and December 2021. Patient demographic data, mechanism of injury, alcohol consumption, helmet usage, sustained injuries and utilized medical resources were recorded. Overall, 268 patients (57% male) with a median age of 30.3 years (IQR 23.3; 40.0) were included. 252 (94%) were e-scooter riders themselves, while 16 (6%) were involved in crashes associated with an e-scooter. Patients in non-rider e-scooter crashes were either cyclists who collided with e-scooter riders or older pedestrians (median age 61.2 years) who tripped over parked e-scooters. While e-scooter riders involved in a crash sustained an impact to the head or face in 58% of cases, those under the influence of alcohol fell on their head or face in 84% of cases. This resulted in a large amount of maxillofacial soft tissue lacerations and fractures. Extremity fractures and dislocations were more often recorded for the upper extremities. This study comprises one of the largest cohorts of e-scooter associated injuries to date. Older pedestrians are at risk to stumble over parked e-scooters. E-scooter crashes with riders who consumed alcohol were associated with more severe injuries, especially to the head and face. Restricted e-scooter parking, enforcement of drunk driving laws for e-scooters, and helmet usage should be recommended.
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Affiliation(s)
- Holger Kleinertz
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Annabelle Volk
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Dimitris Dalos
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.,UKE Athleticum-Center for Athletic Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Rico Rutkowski
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karl-Heinz Frosch
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.,Department of Trauma Surgery, Orthopaedics, and Sports Traumatology, BG Hospital Hamburg, Hamburg, Germany
| | - Darius M Thiesen
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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Kähler A, Püschel K, Ondruschka B, Thiesen D, Kleinertz H, Fitzek A. [One and a half years of e-scooters in Hamburg]. Rechtsmedizin (Berl) 2023; 33:163-169. [PMID: 36624757 PMCID: PMC9815051 DOI: 10.1007/s00194-022-00602-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2022] [Indexed: 01/06/2023]
Abstract
Background Since the spread of the so-called electric scooters (e-scooters) through rental services in Hamburg as of June 2019, accidents due to the use of this means of transportation have been regularly registered. The most frequent injury patterns among e‑scooter riders involved accidents concerning the upper extremities and the head. There was a relevant accumulation of drunk drivers among the injured persons. Objective The aim of the study is to compare injury patterns in drunk versus non-drunk e‑scooter riders who had an accident. Material and methods Data from the Department of Trauma Surgery at the University Medical Center Hamburg-Eppendorf were retrospectively analyzed for accidents involving e‑scooters and the resulting injury patterns. For this purpose, the gender, age, injury pattern of the persons, the course of the accident, and information on previous alcohol consumption were recorded descriptively for the period from June 2019 to December 2021. Results Drivers were on average 32 (interval: 15-88 years) years old and those under the influence of alcohol were predominantly male (69.9%). Accidents occurred mainly in summer and at night. Common injury patterns were injuries to the face, head, and extremities. Conclusion It should be noted that injuries to the face and head occurred more frequently under the influence of alcohol than in the cohort without alcohol. Education about the health and legal consequences of riding an e‑scooter under the influence of alcohol should be provided to all users. In addition, wearing a helmet or banning driving at night are possible measures to reduce accidents associated with drunk riding.
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Affiliation(s)
- Antonia Kähler
- Institut für Rechtsmedizin Hamburg, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - Klaus Püschel
- Institut für Rechtsmedizin Hamburg, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - Benjamin Ondruschka
- Institut für Rechtsmedizin Hamburg, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - Darius Thiesen
- Klinik und Poliklinik für Unfallchirurgie und Orthopädie, Universitätsklinikum Hamburg-Eppendorf, Hamburg-Eppendorf, Deutschland
| | - Holger Kleinertz
- Klinik und Poliklinik für Unfallchirurgie und Orthopädie, Universitätsklinikum Hamburg-Eppendorf, Hamburg-Eppendorf, Deutschland
| | - Antonia Fitzek
- Institut für Rechtsmedizin Hamburg, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
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Arbel S, Zrifin E, Mahmoud R, Mijiritsky E, Groysman L, Shuster A, Rahima H, Kleinman S, Ianculovici C, Peleg O. Maxillofacial Injuries Sustained by Riders of Electric-Powered Bikes and Electric-Powered Scooters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192215183. [PMID: 36429918 PMCID: PMC9690219 DOI: 10.3390/ijerph192215183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/05/2022] [Accepted: 11/09/2022] [Indexed: 06/12/2023]
Abstract
OBJECTIVES The purpose of our study is to retrospectively analyze and compare the patterns of maxillofacial-related injuries among rides of electric-powered bikes (E-bikes) and electric-powered scooters (E-scooters), the associated risk factors, and the required treatment. MATERIALS AND METHODS The medical files of all riders presenting to the emergency department at the Tel Aviv Sourasky Medical Center between 2019 and 2020 with oral- and maxillofacial-related injuries due to E-bike and E-scooter accidents were reviewed. RESULTS A total of 320 riders sustained oral- and maxillofacial-related injuries due to trauma involving E-bikes and E-scooters during the study period. E-scooter riders were involved in 238 accidents (74.5%) while E-bike riders accounted for the remaining 82 accidents (27.5%). Eighty-four out of 320 riders (26.25%) were hospitalized and required surgical interventions. Most of the 232 riders (72.5%) who reported not wearing a protective helmet during the index accident were E-scooter riders. In addition, 39 riders (18.66%) were riding either of these electric-powered vehicles under the influence of alcohol. CONCLUSIONS E-bike riders are more likely to sustain a maxillofacial fracture than E-scooter riders. Not wearing a protective helmet and riding under the influence of alcohol are major risk factors for maxillofacial injuries.
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Affiliation(s)
- Shimrit Arbel
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Elad Zrifin
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Reema Mahmoud
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Eitan Mijiritsky
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Leonid Groysman
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Amir Shuster
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6423906, Israel
| | - Heled Rahima
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Shlomi Kleinman
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Clariel Ianculovici
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Oren Peleg
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
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Abstract
Aims Due to the recent rapid expansion of scooter sharing companies, there has been a dramatic increase in the number of electric scooter (e-scooter) injuries. Our purpose was to conduct a systematic review to characterize the demographic characteristics, most common injuries, and management of patients injured from electric scooters. Methods We searched PubMed, EMBASE, Scopus, and Web of Science databases using variations of the term “electric scooter”. We excluded studies conducted prior to 2015, studies with a population of less than 50, case reports, and studies not focused on electric scooters. Data were analyzed using t-tests and p-values < 0.05 were considered significant. Results We studied 5,705 patients from 34 studies. The mean age was 33.3 years (SD 3.5), and 58.3% (n = 3,325) were male. The leading mechanism of injury was falling (n = 3,595, 74.4%). Injured patients were more likely to not wear a helmet (n = 2,114; 68.1%; p < 0.001). The most common type of injury incurred was bony injuries (n = 2,761, 39.2%), of which upper limb fractures dominated (n = 1,236, 44.8%). Head and neck injuries composed 22.2% (n = 1,565) of the reported injuries, including traumatic brain injuries (n = 455; 2.5%), lacerations/abrasions/contusions (n = 500; 7.1%), intracerebral brain haemorrhages (n = 131; 1.9%), and concussions (n = 255; 3.2%). Standard radiographs comprised most images (n = 2,153; 57.7%). Most patients were treated and released without admission (n = 2,895; 54.5%), and 17.2% (n = 911) of injured patients required surgery. Qualitative analyses of the cost of injury revealed that any intoxication was associated with higher billing costs. Conclusion The leading injuries from e-scooters are upper limb fractures. Falling was the leading mechanism of injury, and most patients did not wear a helmet. Future research should focus on injury characterization, treatment, and cost. Cite this article: Bone Jt Open 2022;3(9):674–683.
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Affiliation(s)
- Priya Singh
- Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Meghana Jami
- Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Joseph Geller
- Department of Orthopedic Surgery, University of Miami, Miami, Florida, USA
| | - Caroline Granger
- Department of Orthopedic Surgery, Washington University, St Louis, Missouri, USA
| | - Lauren Geaney
- Department of Orthopedic Surgery, University of Connecticut, Mansfield, Connecticut, USA
| | - Amiethab Aiyer
- Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Imaging features of electric scooter trauma: what an emergency radiologist needs to know. Radiol Med 2022; 127:872-880. [DOI: 10.1007/s11547-022-01519-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/13/2022] [Indexed: 10/17/2022]
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11
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Slow and Steady Wins the Race: A Comparative Analysis of Standing Electric Scooters’ European Regulations Integrated with the Aspect of Forensic Traumatology. SUSTAINABILITY 2022. [DOI: 10.3390/su14106160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fuel-driven cars are widely considered unsustainable and contrary to the new paradigm of smart growth planning. The need to reform transport behavior, policies, and infrastructure is among the priorities in urban policies around the world. Electric vehicles are an emerging technology that could advance sustainability programs. In the past year, there has been a rapid increase in the diffusion of electric scooters in several European cities, but various states have been unprepared for the rapid spread of green micro-mobility from a regulatory point of view. In addition, in parallel with the spread, there have been numerous road collisions involving standing electric scooters. The aim of this study was to obtain a detailed view of this phenomenon. We focused on the current legislation on electric micro-mobility at the European level to study and summarize the different attitudes adopted by various states whose regulations are present on the web. (It was not possible to evaluate the regulations of all European countries because they are not all available on online platforms.) The elements assessed in the various regulation were age limits, speed limits, compulsory use of helmets, administrative penalties, and the obligation to insure the new e-vehicle (standing scooter). In this study, we analyze the state of the art in electric micro-mobility, highlight the current situation’s limits, and propose new strategies to adequately integrate this new smart vehicle into the urban transport network.
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Suominen EN, Sajanti AJ, Silver EA, Koivunen V, Bondfolk AS, Koskimäki J, Saarinen AJ. 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. Acta Neurochir (Wien) 2022; 164:643-653. [PMID: 35029763 PMCID: PMC8759433 DOI: 10.1007/s00701-021-05098-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 12/19/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Clinicians have increasingly encountered traumatic brain injuries (TBI) related to electric scooter (ES) accidents. In this study, we aim to identify the modifiable risk factors for ES-related TBIs. METHODS A retrospective cohort of consecutive patients treated for ES-related traumatic brain injuries in a tertiary university hospital between May 2019 and September 2021 was identified and employed for the study. The characteristics of the accidents along with the clinical and imaging findings of the injuries were collected from the patient charts. RESULTS During the study period, 104 TBIs related to ES accidents were identified. There was a high occurrence of accidents late at night and on Saturdays. In four cases, the patient's helmet use was mentioned (3.8%). Seventy-four patients (71%) were intoxicated. At the scene of the accident, seventy-seven (74%) of the patients had a Glasgow Coma Scale score of 13-15, three patients (3%) had a score of 9-12, and two patients (2%) had a score of 3-8. The majority (83%) of TBIs were diagnosed as concussions. Eighteen patients had evidence of intracranial injuries in the imagining. Two patients required neurosurgical procedures. The estimated population standardized incidence increased from 7.0/100,000 (95% CI 3.5-11/100,000) in 2019 to 27/100,000 (95% CI 20-34/100,000) in 2021. CONCLUSIONS Alcohol intoxication and the lack of a helmet were common in TBIs caused by ES accidents. Most of the accidents occurred late at night. Targeting these modifiable factors could decrease the incidence of ES-related TBIs.
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Affiliation(s)
- Eetu N Suominen
- Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Antti J Sajanti
- Neurocenter, Department of Neurosurgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Eero A Silver
- Department of Anaesthesia and Intensive Care, University of Turku and Turku University Hospital, Turku, Finland
| | | | - Anton S Bondfolk
- Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Janne Koskimäki
- Neurocenter, Department of Neurosurgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Antti J Saarinen
- Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
- Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
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13
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Rashed S, Vassiliou A, Barber J. Neurosurgical trauma from E-Scooter usage: a review of early case series in London and a review of the literature. Br J Neurosurg 2022; 36:1-12. [PMID: 35023801 DOI: 10.1080/02688697.2021.2024506] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/27/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUND Electric (E-)scooters have become increasingly popular as a means of environmentally friendly and convenient urban transport since 2017. Private use and now ride-sharing schemes are seen in major cities across the world. However, safety data are still lacking especially with concerning reports of significant head injuries. We describe early case series from three hospitals, including a major trauma centre, in East London and review the literature describing neurosurgical trauma from E-scooter usage. METHODS Electronic health records were retrospectively searched for terms related to E-Scooters between 2018 and 2021. Eight case series were included and described. A literature search of PubMed, Ovid MEDLINE and Embase for terms 'E-scooter or electric scooter' was also conducted from inception to 6 March 2021. A total of 825 articles were initially reviewed. Following the removal of duplicates and those meeting the exclusion criteria, 29 articles were analysed in full and included in this review. RESULTS All cases described a head injury of some nature with over half suffering more severe injuries including cranial fractures (most commonly basal skull) or intracerebral haemorrhages (ICH). Spinal fractures were also seen. All required imaging and admission to the hospital. Only a minority required inpatient neurosurgical intervention above conservative measures but almost all required outpatient follow-up. On review of the literature, head injuries were present in 38.8% of all presentations. The majority of which were minor head injuries or concussions; however, approximately 15% involved ICH or skull fractures, respectively. Spinal injuries were less common. Riding while intoxicated and without a helmet was frequently seen within the literature. CONCLUSION This work offers a foundational text highlighting the frequency and severity of neurotrauma seen with E-scooter usage. Injury is seen in E-scooter riders, passengers and pedestrians alike with dangerous riding behaviours likely contributory. A neurosurgical-specific inquiry is recommended for future research.
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Affiliation(s)
- Sami Rashed
- Department of Neurosurgery, The Royal London Hospital, London, UK
| | | | - James Barber
- Department of Neurosurgery, The Royal London Hospital, London, UK
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14
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Toofany M, Mohsenian S, Shum LK, Chan H, Brubacher JR. Injury patterns and circumstances associated with electric scooter collisions: a scoping review. Inj Prev 2021; 27:490-499. [PMID: 33707220 PMCID: PMC8461400 DOI: 10.1136/injuryprev-2020-044085] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Electric scooters are personal mobility devices that have risen in popularity worldwide since 2017. Emerging reports suggest that both riders and other road users, such as pedestrians and cyclists, have been injured in electric scooter-associated incidents. We undertook a scoping review of the current literature to evaluate the injury patterns and circumstances of electric scooter-associated injuries. METHODS A scoping review of literature published from 2010 to 2020 was undertaken following accepted guidelines. Relevant articles were identified in Medline, Embase, SafetyLit and Transport Research International Documentation using terms related to electric scooters, injuries and incident circumstances. Supplemental searches were conducted to identify relevant grey literature (non-peer-reviewed reports). RESULTS Twenty-eight peer-reviewed studies and nine grey literature records were included in the review. The current literature surrounding electric scooter-associated injuries mainly comprises retrospective case series reporting clinical variables. Factors relating to injury circumstances are inconsistently reported. Findings suggest that the head, upper extremities and lower extremities are particularly vulnerable in electric scooter falls or collisions, while injuries to the chest and abdomen are less common. Injury severity was inconsistently reported, but most reported injuries were minor. Low rates of helmet use among electric scooter users were noted in several studies. CONCLUSION Electric scooters leave riders vulnerable to traumatic injuries of varying severity. Future work should prospectively collect standardised data that include information on the context of the injury event and key clinical variables. Research on interventions to prevent electric scooter injuries is also needed to address this growing area of concern.
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Affiliation(s)
- Manish Toofany
- Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sasha Mohsenian
- Faculty of Science, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Leona K Shum
- Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Herbert Chan
- Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Clinical Epidemiology & Evaluation (C2E2), Vancouver, British Columbia, Canada
| | - Jeffrey R Brubacher
- Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Clinical Epidemiology & Evaluation (C2E2), Vancouver, British Columbia, Canada
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15
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Kolokythas A. New Modes of Transportation and Associated Risks. J Oral Maxillofac Surg 2021; 79:1178-1179. [PMID: 33934804 DOI: 10.1016/j.joms.2021.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 02/12/2021] [Indexed: 11/28/2022]
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