Berk Till, Halvachizadeh Sascha, Backup Johannnes, Kalbas Yannik, Rauer Thomas, Zettl Ralph, Pape Hans-Christoph, Hess Florian, Welter Jo Ellen
Department of Trauma Surgery, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
Division of Traumatology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
Patient Saf Surg. 2022 Mar 5;16(1):11. doi: 10.1186/s13037-022-00318-9.
As electric bicycles (e-bikes) become increasingly popular, reports of injuries associated with e-bike usage are also rising. Patterns, characteristics, and severity of injuries following e-bike crashes need further investigation, particularly in contrast to injuries from conventional bicycle crashes.
This prospective observational study included 82 patients treated at a Level II trauma center for injuries resulting from an electric or conventional bicycle crash. Data were collected over one year (05.09.2017-19.09.2018) during in- and outpatient visits. A study-specific case report form was used to identify the bicycle type, cycling behavior (e.g., use of a helmet, safety gear, alcohol), and circumstances of the crash (e.g., road conditions, speed, cause of the incident, time of day, season). Additional information about patient demographics, treatment, and injury characteristics, such as the Injury Severity Score (ISS) and body region injured, were documented. Results were analyzed using chi-square, Fisher's exact, or Wilcoxon tests. Simple logistic or linear regression models were used to estimate associations.
Of the 82 patients, 56 (67%) were riding a conventional bike and 27 (33%) were using an e-bike. Most incidents were either single-bicycle crashes (66%) or automobile collisions (26%), with no notable difference in prevalence rates between groups. Although a higher proportion of conventional bikers were male (67% vs. 48%), the difference was not significant. E-bikers were older (median 60 years (IQR 44-70) vs. 45 years (IQR 32-62); p = 0.008), were hospitalized more often (48% vs. 24%, p = 0.025), and had worse ISS (median 3 (IQR 2-4) vs. 1 (IQR 1-3), p < 0.001), respectively. Body regions most affected were the extremities (78%) and external/skin (46%), and these were distributed similarly in both groups. Concomitant injury patterns of the thorax/chest with external/skin were higher among e-bikers (p < 0.001). When we controlled for the difference in the median age of the two groups, only the injury severity score of e-bikers remained significantly worse.
Hospitalization and chest trauma rates were higher among e-bikers. After controlling for the older age of this group, the severity of their injuries remained worse than in conventional cyclists. Initial clinical assessments at trauma units should include an evaluation of the thorax/chest, particularly among elderly e-bikers.
Level III.
随着电动自行车（e-bike）越来越受欢迎，与电动自行车使用相关的伤害报告也在增加。电动自行车碰撞后损伤的模式、特征和严重程度需要进一步研究，尤其是与传统自行车碰撞造成的损伤相比。
这项前瞻性观察性研究纳入了82例在二级创伤中心接受治疗的因电动或传统自行车碰撞受伤的患者。在一年时间（2017年9月5日至2018年9月19日）内的门诊和住院期间收集数据。使用特定研究的病例报告表来确定自行车类型、骑行行为（如使用头盔、安全装备、饮酒情况）以及碰撞情况（如道路状况、速度、事故原因、一天中的时间、季节）。记录了有关患者人口统计学、治疗和损伤特征的其他信息，如损伤严重程度评分（ISS）和受伤身体部位。使用卡方检验、费舍尔精确检验或威尔科克森检验分析结果。使用简单逻辑回归或线性回归模型来估计关联。
82例患者中，56例（67%）骑传统自行车，27例（33%）使用电动自行车。大多数事故为单车碰撞（66%）或与汽车碰撞（26%），两组患病率无显著差异。虽然骑传统自行车的男性比例较高（67%对48%），但差异不显著。电动自行车骑行者年龄较大（中位数60岁（四分位间距44 - 70）对45岁（四分位间距32 - 62）；p = 0.008），住院频率更高（48%对24%，p = 0.025），ISS更差（中位数3（四分位间距2 - 4）对1（四分位间距1 - 3），p < 0.001）。受影响最严重的身体部位是四肢（78%）和外部/皮肤（46%），两组分布相似。电动自行车骑行者中胸部/胸腔与外部/皮肤的合并损伤模式更高（p < 0.001）。当我们控制两组中位数年龄的差异时，只有电动自行车骑行者的损伤严重程度评分仍然显著更差。
电动自行车骑行者的住院率和胸部创伤率更高。在控制该组年龄较大的因素后，他们的损伤严重程度仍比传统自行车骑行者更差。创伤单元的初始临床评估应包括对胸部/胸腔的评估，尤其是老年电动自行车骑行者。
三级。
