Micromobility Injury Patterns and Resource Use in US Trauma Centers

BACKGROUND: Micromobility-related injuries increasingly contribute to trauma care, but differences in injury patterns and resource use across bicycle, e-bike, and e-scooter injuries remain incompletely characterized. We compared injury severity, injury patterns, and resource use among injured riders presenting to participating trauma centers. STUDY DESIGN: We queried the American College of Surgeons National Trauma Data Bank (2023-2024) for injured bicycle, e-bike, and e-scooter riders ≥18 years. The primary outcome was severe injury (Injury Severity Score ≥16). Secondary outcomes included serious regional injuries (Abbreviated Injury Scale ≥3), craniofacial fractures, operative and critical care resource use, and in-hospital mortality. RESULTS: Among 47,102 injured riders, 32,100 (68%) rode bicycles, 8,744 (19%) e-bikes, and 6,258 (13%) e-scooters. Compared with bicycle riders, e-scooter riders had lower risk of severe injury (aRR 0.93, 95% CI 0.87-0.99) but higher risk of serious head/neck injury (aRR 1.10, 95% CI 1.04-1.17). Risks of serious chest (aRR 0.77, 95% CI 0.71-0.82) and extremities/pelvic girdle injuries (aRR 0.92, 95% CI 0.86-0.99), emergency surgery (aRR 0.66, 95% CI 0.50-0.87), early transfusion (aRR 0.71, 95% CI 0.54-0.94), and in-hospital mortality (aRR 0.78, 95% CI 0.64-0.94) were lower. Helmet use was associated with lower craniofacial fracture risk, most strongly among e-scooter riders (aRR 0.49, 95% CI 0.41-0.58). CONCLUSIONS: Among injured riders presenting to participating trauma centers, e-scooter injuries were associated with lower overall severity and resource use than bicycle injuries but greater serious head/neck injury risk. Helmet use was associated with lower craniofacial fracture risk, supporting continued helmet promotion.