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Impact of E-Scooter Injuries: A Systematic Review of 34 Studies

Category: Trauma; Ankle Introduction/Purpose: Due to the rapid expansion of scooter sharing companies in recent years, there has been a dramatic increase in the number of electric scooter injuries. The purpose of our study was to conduct a systematic review to characterize the demographics, most common injuries, and management of patients injured from electric scooters. Methods: This systematic review searched PubMed, EMBASE, Scopus, and Web of Sciences databases using variations of the terms 'motorized scooter', 'electric scooter', etc. Exclusion criteria included studies prior to 2015, study population less than 50, case reports, presentations or posters only, and studies focused on other devices. Two independent reviewers screened articles and data was analyzed using t-tests with Welch's correction. Sub-group analyses were performed to address data heterogeneity. Results: 5550 patients from 34 studies were included. The median age was 33.07 years, and 58.3% (n=3325) of the patients were male. The most common mechanism of injury was falling (n=3595, 67.3%). Injured patients were more likely to not have been wearing a helmet at the time of injury (70.3%, p<0.001). The most common type of injury incurred were bony injuries (n=2761, 40.2%), of which, the most common fracture location was the upper extremity (n=1236, 44.8%). Head and neck injuries composed 22.2% of the reported injuries, which included traumatic brain injuries (2.5%), lacerations/abrasions/contusions (7.1%), intracerebral brain hemorrhages (1.9%), and concussions (3.2%). Standard radiographs were the most common mode of imaging utilized (n=2153, 57.7%). Most patients were treated and released without admission (n= 2895, 52.2%), and 16.4% of injured patients required surgery. Qualitative analyses of the cost of injury revealed that any intoxication was associated with higher billing costs. Conclusion: Upper extremities fractures were the most common injury type incurred from e-scooter use, and the most common demographics were white, males in their early 30s. There should be more emphasis on wearing protective gear like wrist and elbow guards in addition to helmets. Future prospective studies with larger cohorts across multiple regions and hospitals are necessary to truly characterize the nature and cost of electric scooter injuries.