Injury severity and traumatic brain injuries in youth and adolescents using conventional and electronic bicycles; a retrospective cohort study

Purpose: This study aims to compare the incidence and severity of injuries between young users (10–25 years) of conventional bicycles (c-bikes) and electronic bicycles (e-bikes). Focussing on head and facial injuries.

Methods: A retrospective single-centre cohort study was conducted of patients aged 10 to 25 years who presented to the Emergency Department (ED) following a conventional or electronic bicycle accident. Injury severity was assessed using the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). The Glasgow Coma Scale (GCS) was used to study Traumatic Brain Injuries (TBIs).

Results: 722 patients were included, 82 e-bikers and 640 c-bikers. TBIs (37,8% vs. 19,4%; P < 0.001), cranial haemorrhages (4,9% vs. 0,9%; P = 0.019) and facial fractures (11,0% vs. 3,4% P = 0.011) occurred more often among e-bikers. They had a higher mean ISS (3,7 vs. 2,3; P < 0.001) and mean AIS for head injuries (1,6 vs. 1,3; P = 0.037). They also had a higher relative risk (RR) for TBIs (RR 1.95, 95% CI: 1.32–2.89, p < 0.001), facial fractures (RR 3.19, 95% CI: 1.41–6.93, p = 0.003) and cranial haemorrhages (RR 4.68, 95% CI: 1.12–19.59, p = 0.035).

Conclusion: This study showed that young e-bikers more often suffer severe head and facial trauma compared to c-bikers, as indicated by their higher ISS and AIS scores. This study suggests that the type of bicycle plays a role in sustaining head and facial injuries, and advocates for the use of a helmet while riding an e-bike.