E-Scooter-Associated Injury Types and Injury Severity: A Systematic Review and Meta-Analysis

Background: In the past ten years, the number of publications on injuries associated with electric scooters (e-scooters) has been increasing continuously. The aim of this systematic review and meta-analysis was to synthesize the original study results on injury types, injury severity, clinical care, accident mechanisms, risk factors, and patient characteristics associated with e-scooter accidents. Methods: The literature search was conducted in PubMed, EMBASE and Medline. We included quantitative clinical studies published between 07/2019 and 07/2024 that report e-scooter-associated injuries in patients who presented to an emergency department. Variables that were reported as proportions (e.g., frequency of extremity fractures) were summarized using a proportional meta-analysis. Parameters on a continuous scale were combined using a meta-analysis of the arithmetic means. Results: Among 524 unique records, 149 articles met the inclusion criteria, and 68 were eligible for quantitative analyses. Most e-scooter patients sustained injuries to the head and face with a pooled frequency of 42.1% (95% CI 38.7-45.4). Injuries of the upper extremities were estimated at 40.1% of patients (95% CI 35.8-44.4). Fractures of the extremities occurred with a pooled frequency of 25.7% (95% CI 22.5-28.9). An estimated proportion of 2.3% (95% CI 1.6-3.0) sustained severe traumatic brain injuries. Determined by the Injury Severity Score (ISS), 2.8% (95% CI 1.5-4.1) of the e-scooter patients were severely injured (ISS ≥ 16). Conclusions: Injuries to the head and face as well as the upper extremities are the most common causes for emergency department visits following e-scooter accidents. One in four patients presented with extremity fractures. Severe injuries, however, affect less than three percent of e-scooter patients.