Pediatric electric bicycle injuries and comparison to other pediatric traffic injuries

<b>Objective:</b> The objective of this study was to conduct a comprehensive analysis of demographics, injury characteristics and hospital resource utilization of significant pediatric electric bicycle (e-bike) injuries leading to hospitalization following an emergency department visit in comparison to pediatric injuries caused by other traffic related mechanisms. <b>Methods:</b> A retrospective review of all pediatric traffic injury hospitalizations following an emergency department visit to a level I trauma center between October 2014 and September 2016 was conducted. Data regarding age, sex, number of computed tomography (CT) scans obtained, number of major procedures, length of hospital stay (LOS), Injury Severity Score (ISS), and number of injuries per patient were collected and compared between e-bike injuries and other traffic injuries. <b>Results:</b> Three hundred thirty-seven admissions were analyzed: 46 (14%) were due to e-bike injuries (29% of patients &gt;12 years). Age, proportion of brain injuries, and use of CT were significantly increased compared to mechanical bicycle injuries (13.1 ± 3.4 vs. 10.6 ± 3.6, 13% vs. 3%, 1 [0–3] vs. 1 [0–1], <i>P</i> &lt; .01, <i>P</i> = .03, <i>P</i> = .05). Age, LOS, and use of CT were significantly increased compared to injuries caused to automobile passengers (13.1 ± 3.4 vs. 7.4 ± 5.3, 1 [1–3] vs. 1 [1–2], 1 [0–3] vs. 0 [0–1], <i>P</i> &lt; .01, <i>P</i> = .03, <i>P</i> = .01), as well as ISS and number of injuries per patient (<i>P</i> = .04, <i>P</i> &lt; .01). Injuries caused by e-bikes were similar to injuries caused to pedestrians, except for age (13.1 ± 3.4 vs. 8.5 ± 3.7, <i>P</i> &lt; .01). Multivariable analysis revealed a significant association between mechanism of injury and ISS, with increased ISS among e-bike injuries compared to mecahnical bike injuries (OR 2.56, CI 1.1–5.88, <i>P</i> = 0.03) and automobile injuries (OR 4.16, CI 1.49–12.5, (<i>P</i> &lt; .01). <b>Conclusion:</b> E-bikes are a significant cause of severe injury in children compared to most other traffic injuries, particularly in older children.

**研究目标：** 本研究旨在全面分析经急诊科就诊后需住院治疗的严重儿童电动自行车（electric bicycle，e-bike）创伤的人口学特征、创伤特点及医院资源利用情况，并与其他交通相关机制导致的儿童创伤进行对比。**研究方法：** 本研究回顾性分析了2014年10月至2016年9月期间，某一级创伤中心急诊科就诊后住院的所有儿童交通创伤病例。收集并比较电动自行车创伤与其他交通创伤患者的年龄、性别、计算机断层扫描（computed tomography，CT）检查次数、大型手术次数、住院时长（length of hospital stay，LOS）、创伤严重程度评分（Injury Severity Score，ISS）以及每位患者的创伤数量。**研究结果：** 本研究共纳入337例住院病例进行分析：其中46例（14%）由e-bike创伤导致（12岁以上患者占比29%）。与普通自行车创伤组相比，e-bike创伤组的患者年龄、颅脑创伤占比及CT检查使用率均显著更高（年龄：13.1±3.4 vs 10.6±3.6；颅脑创伤占比：13% vs 3%；CT检查次数：1[0–3] vs 1[0–1]，*P*<0.01、*P*=0.03、*P*=0.05）。与汽车乘客创伤组相比，e-bike创伤组的患者年龄、住院时长、CT检查使用率均显著更高（年龄：13.1±3.4 vs 7.4±5.3；住院时长：1[1–3] vs 1[1–2]；CT检查次数：1[0–3] vs 0[0–1]，*P*<0.01、*P*=0.03、*P*=0.01），且创伤严重程度评分及每位患者的创伤数量也显著更高（*P*=0.04、*P*<0.01）。e-bike创伤与行人创伤的各项指标仅在年龄上存在显著差异（年龄：13.1±3.4 vs 8.5±3.7，*P*<0.01），其余指标相似。多变量分析显示，创伤机制与创伤严重程度评分存在显著关联：相较于普通自行车创伤组，e-bike创伤组的创伤严重程度评分显著更高（比值比（odds ratio，OR）=2.56，置信区间（confidence interval，CI）=1.1~5.88，*P*=0.03）；相较于汽车乘客创伤组，e-bike创伤组的创伤严重程度评分同样显著更高（OR=4.16，CI=1.49~12.5，*P*<0.01）。**研究结论：** 与大多数其他交通创伤相比，电动自行车是导致儿童严重创伤的重要诱因，尤其在年龄较大的儿童群体中更为显著。