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Baschera D, Jäger D, Preda R, Z'Graggen WJ, Raabe A, Exadaktylos AK, Hasler RM. World Neurosurg. 2019; ePub(ePub): ePub.


Department of Emergency Medicine, Inselspital, Bern University Hospital, Bern, Switzerland. Electronic address:


(Copyright © 2019, Elsevier Publishing)






BACKGROUND: Electrical bicycles (E-bikes) allow people of all ages to ride at high speeds, but have an inherent risk of traumatic brain injury (TBI). Their sales have increased tremendously in recent years METHOD: This is a retrospective cohort study comparing the incidence and severity of TBI in E-bikers and conventional cyclists. It includes patients at a Swiss level 1 trauma center admitted between 2010 and 2015. The primary outcome was the association between TBI and the type of bicycle. The secondary outcome was the association between helmet use and the severity of TBI.

RESULTS: Of 557 patients injured riding an E-bike (n=73) or bicycle (n=484), 60% sustained TBI, which was mostly mild (Glasgow Coma Scale (GCS) 13-15) (E-bike 78%, bicycle 88%). TBI was more often moderate (GCS 9-12) or severe (GCS 3-8) in E-bikers than in bicyclists (p=0.04). Intracranial hemorrhage, traumatic subarachnoid hemorrhage and subdural hematoma occurred significantly more often in E-bikers than in bicyclists (p<0.05). Neurosurgical intervention was necessary in 5 E-bikers (7%) and 25 (5%) bicyclists (p=0.15). Wearing a helmet was correlated with a lower risk of neurosurgical intervention in bicyclists (p=0.01; OR 0.21 (CI95 0.06-0.73)) and with a lower risk of calvarial fractures in both bicyclists (p<0.01; OR 0.16 (CI95 0.06-0.42)) and E-bikers (p=0.03; OR 0.21 (CI95 0.05-0.84)).

CONCLUSION: E-bikers had a significantly higher risk of moderate to severe TBI than bicyclists. Helmet use was associated with decreased odds of severe TBI in bicyclists and a tendency towards a more favorable outcome in E-bikers.

Copyright © 2019 Elsevier Inc. All rights reserved.

Language: en


E-bike; TBI; bicycle; head trauma; helmet


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