Neurosurgical Injuries Related to Electric vs. Non-electric Bike and Scooter Accidents in New York City: A Retrospective, Observational, Case-control Study

Introduction: The use of electric bicycles and scooters has significantly increased over recent years. Data on outcomes of neurosurgical injuries related to widespread introduction of electric scooters/bikes in New York City has not yet been reported. We describe trends in New York City and the associated effect on prevalence and severity of neurosurgical injuries as observed in a Manhattan level one trauma center.

Methods: We performed a single-site, retrospective study to analyze demographic and clinical features of electric and traditional scooter/bike neurosurgery trauma patients at Bellevue Hospital, a level one trauma center in Manhattan, from January 2018 to June 2022.

Results: A total of 750 patients (81% male, average age 39 [IQR 22]) were analyzed, 198 (26%) were involved in electric scooter/bike accidents. The rates of electric scooter/bike accidents increased from 8% (n=7) in 2018 to 48% (n=57) in 2022 (p < 0.001). Overall average monthly accidents tripled between 2018 and 2022. Patients on electric scooters/bikes were associated with increased imaging severity (p=0.02) and likelihood of being admitted (p < 0.001) and decreased likelihood of discharge home (p=0.001) compared to non-electric scooter/bike patients. When comparing only patients that were admitted to the hospital, there was no statistical difference in imaging severity (p=0.225) or disposition to home (p=0.735). In pedestrians hit by scooters/bikes, there was no statistical difference in severity of imaging (p=0.717), need for admission (p=0.614) or neurosurgical intervention (p=0.696). Patients on electric scooters/bikes trended towards being more likely to wear a helmet but this was not statistically significant (p=0.073).

Conclusion : The prevalence of electric scooters/bikes in New York City and associated injuries has increased over the last four years. However, in this cohort riders of electric vehicles do not present with more severe neurosurgical injuries. Further inquiry of this data may allow for improvement in public safety policies and patient outcomes in future.