E-scooter use continues to rev up fracture diagnoses and hospital admissions compared to other modes of transportation

Eric H Tischler; Benjamin Krasnyanskiy; Ryan M Kong; Olivia Tracey; Sung Huang Laurent Tsai; Nishant Suneja

doi:10.1016/j.jcot.2023.102164

E-scooter use continues to rev up fracture diagnoses and hospital admissions compared to other modes of transportation

J Clin Orthop Trauma. 2023 Apr 27:40:102164. doi: 10.1016/j.jcot.2023.102164. eCollection 2023 May.

Authors

Eric H Tischler¹, Benjamin Krasnyanskiy¹, Ryan M Kong¹, Olivia Tracey¹, Sung Huang Laurent Tsai^{2

3}, Nishant Suneja^{1

4}

Affiliations

¹ Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
² Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung, 204, Taiwan.
³ School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
⁴ Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.

Abstract

Introduction: The COVID-19 pandemic was associated with an increase in popularity of e-scooter usage and a rise in e-scooter related injuries. Recent studies have elucidated trends within e-scooter injuries but there are few epidemiological studies that evaluate injury rates amongst multiple modes of transportation. This study seeks to investigate trends of e-scooter orthopedic fracture injuries compared to other traditional methods of transportation using a national database.

Methods: The National Electronic Injury Surveillance System (NEISS) database was queried between 2014 and 2020 for patients who were injured after usage of e-scooters, bicycles, or all-terrain vehicles. Primary analysis included patients with a diagnosis of fracture and utilized univariate/multivariate models to evaluate risk of hospital admission. Secondary analysis included all isolated patients to evaluate the odds of fracture development amongst modes of transportation.

Results: A total of 70,719 patients with injuries associated with e-scooter, bicycle, or all-terrain vehicle use were isolated. 15997 (22.6%) of these patients had a fracture diagnosis. Both e-scooters and all-terrain vehicles reported increased odds of fracture-related injury and direct hospitalization when compared to bicycles. E-scooter users reported a greater odds of both associated fracture (OR 1.25; 95%CI 1.03-1.51; p = 0.024) and hospital admission (OR: 2.01; 95%CI: 1.26-3.21; p = 0.003) in 2020 compared to 2014-2015.

Discussion: E-scooter related orthopedic injuries and hospital admissions had the largest incidence rate increase compared to bicycle and all-terrain vehicles between 2014 and 2020. E-scooter fractures were most commonly located in the lower leg in 2014-2017, the wrist in 2018-2019, and the upper trunk in 2020. In comparison, bicycle and all-terrain vehicle fractures was most commonly shoulder and upper trunk within the study period. Further research will help to promote further understanding of the e-scooter health care burden and in prevention of these injuries.

Level of evidence: 3.

Keywords: All-terrain; Bicycle; Epidemiology; Orthopedics; Trauma.