The peri-operative burden of e-bike and e-scooter injuries in Greater London: a prospective cohort study

The contribution of e-bike and e-scooter injuries to peri-operative activity across a trauma network is poorly characterised. We conducted a prospective cohort study across 24 London hospitals from 30/03/2026 to 12/04/2026 to measure the proportion of urgent and emergency operations associated with these injuries and describe the peri-operative resource use. Thirty-one patients underwent one operation each, accounting for 31/3327 (0.9%) urgent and emergency operations. E-bikes were involved in 26/31 (84%) injuries. Median operative duration was 153 (110-221 [19-405]) min; 7/31 (23%) operations occurred out of hours and 3/31 (10%) required immediate life- or limb-saving surgery. Orthopaedics accounted for 26/31 (84%) cases. Six of 31 patients (19%) required postoperative critical care and 7/31 (23%) spent at least 1 week in hospital. Most patients (22/31; 71%) presented to trauma units. Exploratory estimates for the included ambulance, emergency department, theatre, hospital stay and major haemorrhage components were £224,658-£373,820 under low- and high-cost assumptions, respectively. Theatre time was the largest component. These injuries accounted for a small proportion of operations, but some patients required immediate surgery, out-of-hours operating or critical care. Their occurrence across trauma units and major trauma centres supports including both settings and peri-operative outcomes in future surveillance. Longer, seasonally representative surveillance and more complete follow-up are needed to estimate annual operative workload and costs.