Department of Emergency Medicine, Noordwest Ziekenhuisgroep, Alkmaar, Noord-Holland, The Netherlands
Department of Emergency Medicine, Noordwest Ziekenhuisgroep, Alkmaar, Noord-Holland, The Netherlands.
Emerg Med J. 2021 Apr;38(4):279-284. doi: 10.1136/emermed-2019-208811. Epub 2021 Jan 20.
E-bike usage is increasingly popular and concerns about e-bike-related injuries and safety have risen as more injured e-bikers attend the emergency department (ED). Traumatic brain injury (TBI) is the main cause of severe morbidity and mortality in bicycle-related accidents. This study compares the frequency and severity of TBI after an accident with an e-bike or classic bicycle among patients treated in the ED.
This was a prospective cohort study of patients with bicycle-related injuries attending the ED of a level 1 trauma centre in the Netherlands between June 2016 and May 2017. The primary outcomes were frequency and severity of TBI (defined by the Abbreviated Injury Scale head score ≥1). Injury Severity Score, surgical intervention, hospitalisation and 30-day mortality were secondary outcomes. Independent risk factors for TBI were identified with multiple logistic regression.
We included 834 patients, of whom there were 379 e-bike and 455 classic bicycle users. The frequency of TBI was not significantly different between the e-bike and classic bicycle group (respectively, n=56, 15% vs n=73, 16%; p=0.61). After adjusting for age, gender, velocity, anticoagulation use and alcohol intoxication the OR for TBI with an e-bike compared with classic bicycle was 0.90 (95% CI 0.56 to 1.45). Independent of type of bicycle, TBI was more likely if velocity was 26-45 km/hour, OR 8.14 (95% CI 2.36 to 28.08), the patient was highly alcohol intoxicated, OR 7.02 (95% CI 2.88 to 17.08) or used anticoagulants, OR 2.18 (95% CI 1.20 to 3.97). TBI severity was similar in both groups (p=0.65): eight e-bike and seven classic bicycle accident victims had serious TBI.
The frequency and severity of TBI among patients treated for bicycle-related injuries at our ED was similar for e-bike and classic bicycle users. Velocity, alcohol intoxication and anticoagulant use were the main determinants of the risk of head injury regardless of type of bicycle used.
随着越来越多的电动自行车骑手前往急诊科（ED），人们对电动自行车相关伤害和安全问题的担忧也与日俱增。电动自行车相关事故中创伤性脑损伤（TBI）是导致严重发病率和死亡率的主要原因。本研究比较了在 ED 接受治疗的电动自行车或经典自行车相关事故患者 TBI 的发生频率和严重程度。
这是一项在荷兰一级创伤中心 ED 接受治疗的自行车相关损伤患者的前瞻性队列研究。主要结局为 TBI 的发生频率和严重程度（定义为简明损伤量表头部评分≥1）。损伤严重程度评分、手术干预、住院和 30 天死亡率为次要结局。采用多因素逻辑回归识别 TBI 的独立危险因素。
我们纳入了 834 名患者，其中电动自行车患者 379 名，经典自行车患者 455 名。电动自行车和经典自行车组 TBI 的发生率无显著差异（分别为 56 例，15%；73 例，16%；p=0.61）。在校正年龄、性别、速度、抗凝药物使用和酒精中毒后，电动自行车组 TBI 的 OR 为 0.90（95%CI 0.56 至 1.45）。与自行车类型无关，如果速度为 26-45km/h，TBI 的发生风险更高，OR 8.14（95%CI 2.36 至 28.08）；患者高度酒精中毒，OR 7.02（95%CI 2.88 至 17.08）；或使用抗凝药物，OR 2.18（95%CI 1.20 至 3.97），TBI 的发生风险也更高。两组 TBI 的严重程度相似（p=0.65）：8 名电动自行车和 7 名经典自行车事故受害者有严重 TBI。
在我们 ED 接受治疗的自行车相关损伤患者中，电动自行车和经典自行车使用者 TBI 的发生频率和严重程度相似。速度、酒精中毒和抗凝药物使用是无论使用何种自行车，导致头部受伤风险的主要决定因素。
