Sher Theo, Shah Jay, Holbrook Emily A, Thomas Andrew, Wilson Jason
Emergency Medicine, University of South Florida Morsani College of Medicine, Tampa, USA.
Anthropology, University of South Florida, Tampa, USA.
Cureus. 2023 May 26;15(5):e39523. doi: 10.7759/cureus.39523. eCollection 2023 May.
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.
背景 站立式电动滑板车于2019年在佛罗里达州坦帕市投入使用。我们回顾了坦帕综合医院急诊科(ED)的292例电动滑板车损伤病例,以确定能从中获得哪些见解。我们试图确定此类就诊病例的特征,包括主诉(CC)、患者年龄、星期几、一天中的时间、住院时间、处置方式、 acuity(此处原文有误,可能是acuity,意为 acuity,指敏锐度、急性程度等,暂按“急性程度”翻译)、到达急诊科的方式。我们特别关注研究住院率、紧急医疗服务(EMS)转运率、急性程度较高的就诊病例以及头部损伤情况。我们还试图确定电动滑板车事故前饮酒的普遍性及其对上述因素的影响。
方法 这是一项回顾性病历审查,无需南佛罗里达大学机构审查委员会批准(研究编号:STUDY004031)。通过医院电子病历系统商业智能基础设施中的运营报告,收集了2019年7月19日至2022年5月30日期间,佛罗里达州坦帕市一级创伤中心急诊科坦帕综合医院急诊科的常规临床护理数据。将与滑板车损伤相关的就诊编码患者的数据提取到电子数据采集表中,并进行去标识化处理。审查病历叙述以排除不确定病例(如助力车、儿童滑板车、代步滑板车损伤等患者),并标记酒精使用情况、精神状态改变、头盔使用情况以及未列为主要诉求的头部损伤。收集了主诉、到达方式、急性程度、处置方式、到达/离开星期几以及到达/离开时间。使用Microsoft Excel 16.5版本(美国华盛顿州雷德蒙德市微软公司)和SPSS Statistics 28.0版本(美国纽约州阿蒙克市IBM公司)完成数据分析。
结果 在去除无关标记后,442例收集病例中共有292例留存。总体而言,30.8%(n = 90)的患者年龄在21岁至30岁之间,大多数患者在周末和夜间就诊。此外,40.8%(n = 119)的患者头部受伤,40.8%(n = 119)通过EMS送达,31.5%(n = 92)住院,18.8%(n = 55)被指定为急性程度较高的病例。除住院率外,这些比率在有酒精使用记录者(39例,13.4%)中均高于无酒精使用记录者(253例,86.6%)。只有2.1%的患者表示使用了头盔。
结论 我们发现,我们急诊科的住院率和EMS转运率高于之前许多城市地区研究报告的水平。我们的数据表明,饮酒会增加电动滑板车更严重损伤的风险,其特征是有酒精使用记录者的急性程度更高、EMS转运率更高以及头部受伤率更高。鉴于电动滑板车在美国迅速普及,这些发现具有高度相关性,可能有助于告知医院和EMS系统它们在损伤管理中的作用,以及关于其安全使用的未来政策。