Comparison of the Incidence and Severity of Traumatic Brain Injury Caused by Electrical Bicycle and Bicycle Accidents-A Retrospective Cohort Study From a Swiss Level I Trauma Center.

Baschera, Dominik; Jäger, Damian; Preda, Raluca; Z'Graggen, Werner J.; Raabe, Andreas; Exadaktylos, Aristomenis K.; Hasler, Rebecca M. (2019). Comparison of the Incidence and Severity of Traumatic Brain Injury Caused by Electrical Bicycle and Bicycle Accidents-A Retrospective Cohort Study From a Swiss Level I Trauma Center. World neurosurgery, 126, e1023-e1034. Elsevier 10.1016/j.wneu.2019.03.032

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BACKGROUND

Electrical bicycles (E-bikes) allow people of all ages to ride at high speeds but have an inherent risk of traumatic brain injury (TBI). Their sales have increased tremendously in recent years.

METHODS

We performed a retrospective cohort study to compare the incidence and severity of TBI in E-bikers and conventional bicyclists. We included patients at a Swiss level 1 trauma center admitted from 2010 to 2015. The primary outcome was the association between TBI and the bicycle type. The secondary outcome was the association between helmet use and TBI severity.

RESULTS

Of 557 patients injured riding an E-bike (n = 73) or a bicycle (n = 484), 60% sustained a TBI, most of which were mild (Glasgow coma scale [GCS] score, 13-15; E-bike, 78%; bicycle, 88%). TBI was more often moderate (GCS score, 9-12) or severe (GCS score, 3-8) in E-bikers than in bicyclists (P = 0.04). Intracranial hemorrhage, traumatic subarachnoid hemorrhage, and subdural hematoma occurred significantly more often in E-bikers than in bicyclists (P < 0.05). Neurosurgical intervention was necessary for 5 E-bikers (7%) and 25 (5%) bicyclists (P = 0.15). Wearing a helmet correlated with a lower risk of neurosurgical intervention in bicyclists (odds ratio [OR], 0.21; 95% confidence interval [CI], 0.06-0.73; P = 0.01) and a lower risk of calvarial fractures in both bicyclists (OR, 0.16; 95% CI, 0.06-0.42; P < 0.01) and E-bikers (OR, 0.21; 95% CI, 0.05-0.84; P = 0.03).

CONCLUSIONS

E-bikers had a significantly greater risk of moderate to severe TBI compared with bicyclists. Helmet use was associated with decreased odds of severe TBI in bicyclists and a tendency toward a more favorable outcome for E-bikers.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Preda, Raluca, Z'Graggen, Werner Josef, Raabe, Andreas, Exadaktylos, Aristomenis, Hasler, Rebecca Maria

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1878-8750

Publisher:

Elsevier

Language:

English

Submitter:

Nicole Söll

Date Deposited:

27 Aug 2019 10:21

Last Modified:

05 Dec 2022 15:30

Publisher DOI:

10.1016/j.wneu.2019.03.032

PubMed ID:

30857998

Uncontrolled Keywords:

Bicycle E-bike Head trauma Helmet TBI

BORIS DOI:

10.7892/boris.132394

URI:

https://boris.unibe.ch/id/eprint/132394

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