| Literature DB >> 34639579 |
Bjorn Anderson1, Jonathan D Rupp2,3, Tim P Moran2, Lauren A Hudak2, Daniel T Wu2,4.
Abstract
Safety policy for e-scooters in the United States tends to vary by municipality, and the effects of safety interventions have not been well studied. We reviewed medical records at a large, urban tertiary care and trauma center in Atlanta, Georgia with the goal of identifying trends in e-scooter injury and the effects of Atlanta's nighttime ban on e-scooter rentals on injuries treated in the emergency department (ED). Records from all ED visits occurring between June 2018 through August 2020 were reviewed. To account for ambiguity in medical records, confidence levels of either "certain" or "possible" were assigned using a set of predefined criteria to categorize patient injuries as being associated with an e-scooter. A total of 380 patients categorized as having certain e-scooter related injuries were identified. The average age of these patients was 31 years old, 65% were male, 41% had head injuries, 20% of injuries were associated with the built environment, and approximately 20% were admitted to the hospital. Approximately 19% of patients with injuries associated with e-scooters noted to be clinically intoxicated or have a serum ethanol level exceeding 80 mg/dL. The implementation of a nighttime rental ban on e-scooter rentals reduced the proportion of patients with e-scooter injuries with times of arrival during the hours of the ban from 32% to 22%, however this effect was not significant (p = 0.16). More research is needed to understand how e-scooter use patterns are affected by the nighttime rental ban.Entities:
Keywords: e-scooter injury costs; micromobilty; nighttime ban
Mesh:
Year: 2021 PMID: 34639579 PMCID: PMC8507613 DOI: 10.3390/ijerph181910281
Source DB: PubMed Journal: Int J Environ Res Public Health ISSN: 1660-4601 Impact factor: 3.390
Criteria Used to Identify and Assign Confidence to Patients with e-Scooters Injuries in Manual Review of Provider Notes.
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| Injury related to use of a e-scooter described as a motorized “upright”, “standing” or “push” scooter; “electric” or “electronic” “scooter”; “escooter” or “e-scooter”; and/or a specific brand of commercially available rentable e-scooter anywhere in documentation. |
| Mention of being “driver” of scooter described as “push”, “standing”, “stand up”, or “upright” in the absence of characterization as motorized or electric device anywhere in documentation. |
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| Description of e-scooter as a scooter or motorized scooter without further characterization or along with use of “seated”, “seat,” “moped”, “motorcycle” or “bike” in description of device. |
| Criteria for certain not met. |
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| Use of e-scooter at speeds unattainable by commercially available e-scooters and in described as being in a seated position/on a seat. |
| Mention of use or brand specific to non-e-scooters such as “vespa”, “kickstarting”, “switching gears”, “razor” or “arm rests” |
| Description of device as a mobility scooter |
| Patient has chronic medical condition prohibiting ability to use standing/upright electric scooter. |
| Description of the scooter as a wheelchair or dirt bike without meeting definite positive or possible criteria. |
| Presentation with psychiatric or medical chief complaint without evidence of trauma meeting definite positive or possible criteria. |
| Initial Patient presentation or EMS transport from a location outside deployment regions of commercially available rentable upright dockless electric scooters. |
| Subsequent encounters for the same e-scooter injury, or reinjury of old e-scooter-related injury by mechanism other than e-scooter use. |
| Criteria for certain and possible not met. |
Figure 1Results of the process used to identify e-Scooters from medical records.
Characteristics of Patients with Injuries with e-Scooters Injuries Classified as Certain.
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| Age (Years) | 31 (23–41) |
| Charges (USD) | 9608 (3591–24,252) |
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| Race/Ethnicity | |
| Native American | 2 (0.5) |
| Asian | 15 (3.9) |
| Black | 211 (55.5) |
| Hispanic | 18 (4.7) |
| Multi-Racial | 8 (2.1) |
| Other | 1 (0.3) |
| White | 125 (32.9) |
| Time of Arrival † | |
| 21:00–03:59 | 96 (30.0) |
| 04:00–09:59 | 41 (12.8) |
| 10:00–15:59 | 80 (25.0) |
| 16:00–20:59 | 103 (32.2) |
| Disposition †† | |
| Admitted | 71 (19.0) |
| Discharged | 299 (80.2) |
| Death | 1 (0.3) |
| Transferred | 2 (0.5) |
| Insurance | |
| Commercial | 159 (41.8) |
| Medicaid | 47 (12.4) |
| Medicare | 14 (3.7) |
| Self-pay | 160 (42.1) |
| Mechanism of Injury | |
| Fall | 281 (73.9) |
| MV | 61 (16.1) |
| Other/Unknown | 10 (2.6) |
| Struck Against | 23 (6.1) |
| Struck By | 5 (1.3) |
| EtOH (serum ethanol) | |
| EtOH < 80 mg/dL | 53 (16.6) |
| EtOH ≥ 80 mg/dL | 29 (9.1) |
| Clinically Intoxicated | 33 (10.3) |
| Not Intoxicated/Tested | 205 (64.1) |
| Helmet | |
| Not Recorded | 290 (76.3) |
| No | 79 (20.8) |
| Yes | 11 (2.9) |
| Built Environment | 75 (19.7) |
| Head Injury | 156 (41.1) |
† Excludes patients with delayed presentations; †† Excludes patients with complex presentations.
Figure 2Total and certain e-scooter injuries by month.
Figure 3(A) A density plot depicting the distribution of arrival times for certain e-scooter patients as a function of the night time ban (12:00 a.m. is set to hour 0); the difference between the distributions was not significant (p = 23), (B) A bar graph depicting the percentage of certain scooter patients as a function of time of day and night time ban, the effect of the nighttime ban was not significant (p = 16), (C) A density plot depicting the distribution of arrival times for certain scooter patients transported by Emergency Medical Services (EMS) as a function of the night time ban; the difference between distributions is not significant (p = 0.18), (D) A bar graph depicting the percentage of certain scooter patients transported by EMS as a function of time of day and night time ban; the effect of the nighttime ban was not significant (p = 32).
Results of univariate statistical analysis comparing certain with possible bicycle injuries.
| Characteristic | Certain | Uncertain |
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|---|---|---|---|---|
| Age | 31 | 31 | 0.55 | 1 |
| Charges | 9608 | 6220.6 | 0.004 | 0.03 |
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| Race/Ethnicity | <0.001 | <0.001 | ||
| Native American | 2 (0.5) | 1 (0.3) | ||
| Asian | 15 (3.9) | 5 (1.4) | ||
| Black | 211 (55.5) | 254 (73.2) | ||
| Hispanic | 18 (4.7) | 11 (3.2) | ||
| Multi-Racial | 8 (2.1) | 2 (0.6) | ||
| Other | 1 (0.3) | 3 (0.9) | ||
| White | 125 (32.9) | 71 (20.5) | ||
| Time of Arrival | 0.57 | 1 | ||
| Disposition | 0.67 | 1 | ||
| Admitted | 71 (19) | 50 (15.5) | ||
| Discharged | 299 (80.2) | 269 (83.5) | ||
| Death | 1 (0.3) | 1 (0.3) | ||
| Transferred | 2 (0.5) | 2 (0.6) | ||
| Insurance | 0.002 | 0.02 | ||
| Commercial | 159 (41.8) | 98 (28.2) | ||
| Medicaid | 47 (12.4) | 57 (16.4) | ||
| Medicare | 14 (3.7) | 12 (3.5) | ||
| Self-pay | 160 (42.1) | 180 (51.9) | ||
| Mechanism of Injury | <0.001 | <0.001 | ||
| Fall | 281 (73.9) | 233 (67.1) | ||
| MV | 61 (16.1) | 54 (15.6) | ||
| Other/Unknown | 10 (2.6) | 39 (11.2) | ||
| Struck Against | 23 (6.1) | 9 (2.6) | ||
| Struck By | 5 (1.3) | 12 (3.5) | ||
| EtOH (serum ethanol) | 0.11 | 0.82 | ||
| EtOH <80 mg/dL | 53 (16.6) | 49 (20.7) | ||
| EtOH ≥ 80 mg/dL | 29 (9.1) | 20 (8.4) | ||
| Clinically Intoxicated | 33 (10.3) | 12 (5.1) | ||
| Not Clinically Intoxicated/Tested | 205 (64.1) | 156 (65.8) | ||
| Helmet | <0.001 | <0.001 | ||
| Not Recorded | 290 (76.3) | 265 (76.4) | ||
| No | 79 (20.8) | 47 (13.5) | ||
| Yes | 11 (2.9) | 35 (10.1) | ||
| Built Environment | 75 (19.7) | 30 (8.6) | <0.001 | <0.001 |
| Head Injury | 156 (41.1) | 97 (28) | <0.001 | 0.003 |
| Acuity | <0.001 | <0.001 | ||
| Emergent | 30 (8) | 25 (7.7) | ||
| Immediate | 10 (2.7) | 12 (3.7) | ||
| Less Urgent | 60 (16.1) | 94 (29.1) | ||
| Non-Urgent | 1 (0.3) | 13 (4) | ||
| Urgent | 272 (72.9) | 179 (55.4) |
† False Discovery Rate corrected for multiple comparisons.