Hospital-Based Injury Patterns Among Motorcycle Couriers and Pedestrians Struck by Courier-Operated Motorcycles and...

Background and Objectives: Courier-operated motorcycles and mopeds have become increasingly visible in urban traffic, raising concerns about injuries among both couriers and pedestrians struck by courier-operated vehicles. The study period coincided with the COVID-19 pandemic; however, this study was not designed to evaluate the effect of the pandemic on courier-related injuries. This multicenter retrospective study aimed to describe hospital-based injury patterns, injury severity, treatment requirements, complications, and mortality among selected courier-related casualties, including motorcycle couriers and pedestrians struck by courier-operated motorcycles or mopeds. Materials and Methods: This retrospective multicenter observational study included courier-related traffic casualties identified between 1 March 2020, and 1 June 2022, through nine hospitals in İstanbul and Ankara and, for fatal courier cases, linked emergency medical service and hospital records. The primary clinical cohort consisted of injured couriers and pedestrians evaluated or treated at participating hospitals. Linked prehospital and early fatal courier cases were analyzed separately for mortality-related and mechanism-specific fatality analyses. Injury severity was assessed using the New Injury Severity Score. Treatment was classified as conservative or surgical, including both fracture fixation and soft-tissue procedures. Results: A total of 857 courier-related traffic casualties were identified, including 491 couriers and 366 pedestrians. Among couriers, 111 fatal cases were verified through linked records. Clinical treatment and follow-up analyses were restricted to 380 hospital-treated surviving couriers and 366 pedestrians with available clinical records. In this selected hospital-treated courier cohort, multiple fractures, open fractures, higher injury severity scores, surgical treatment, and complications were more frequent than among pedestrians. All hospital-treated surviving couriers included in the orthopedic trauma cohort underwent surgery, reflecting the orthopedic trauma-based case-identification process, whereas most pedestrians were treated conservatively. Conclusions: Among this selected hospital-based cohort, courier casualties identified through hospital, trauma referral, emergency, forensic, and linked fatal-event records showed a more severe clinical profile than pedestrians evaluated after being struck by courier-operated motorcycles or mopeds. These findings should be interpreted as hospital-based injury-severity patterns rather than population-level estimates of accident incidence, relative injury risk, or public health burden.