# The Impact of Helmet Use on Injury Severity and Clinical Outcomes in E-Bike Riders

## TL;DR

This study shows that e-bike riders who wear helmets have better clinical outcomes, like higher GCS scores and fewer ventilator days, though overall helmet use remains low.

## Contribution

The study provides empirical evidence on the impact of helmet use on injury severity and clinical outcomes in e-bike riders using a large trauma database.

## Key findings

- Helmet use was associated with higher Glasgow Coma Scale scores and fewer ventilator days.
- Approximately 30-33% of e-bike riders aged 20-60 used helmets during incidents.
- Injury Severity Score and hospital length of stay did not significantly differ between helmeted and non-helmeted riders.

## Abstract

Introduction

As electric bicycles (e-bikes) surge in popularity, understanding their impact on rider safety has never been more critical. This study presents a comprehensive analysis of helmet use trends, as well as the efficacy of helmet use in e-bike-related incidents. Key areas of analysis include demographics, injury severity, helmet use, and various clinical outcomes. With the significant rise in e-bike use in recent years, this study aims to evaluate trends in e-bike-related accidents and assess the role of helmet use in reducing injury severity and improving patient outcomes.

Methods

A retrospective analysis was performed using the National Trauma Data Standard (NTDS) from 2018 to 2023 to assess e-bike-related injuries. Patients were identified using 77 specific ICD-10 codes related to e-bike incidents, with 5,474 cases meeting the inclusion criteria. Demographic variables, injury markers, and clinical outcomes - including helmet use, hospital length of stay, ventilator days, Glasgow Coma Scale (GCS), and Injury Severity Score (ISS) - were analyzed. Statistical comparisons between helmeted and non-helmeted patients were conducted using Python 3.12.6, employing two-sided Welch’s t-tests and Student’s t-tests.

Results

A total of 7,018,732 patients were screened, yielding 5,474 cases of e-bike-related injuries between 2018 and 2023. The mean patient age was 41.1 ± 19.2 years, with 82% (4,493) being male. Demographic data revealed that 1,701 (31.1%) cases involved patients aged 40-60, followed by 1,674 (30.6%) cases aged 20-40, with helmet use rates of 29.5% (501) and 33.4% (559), respectively. Nearly 50% (2,592) of accidents involved traffic-associated collisions, with approximately 25% (1,395) of those incidents involving a car, pick-up truck, or van. Helmet use was associated with fewer ventilator days (0.43 ± 3.16 vs. 0.67 ± 3.93, p = 0.0148) and higher GCS scores (13.98 ± 3.28 vs. 13.75 ± 3.52, p = 0.0141) compared to the non-helmeted group. However, ISS and total hospital days showed no statistically significant differences between the two groups.

Conclusion

This study demonstrates that helmet use among e-bike riders is associated with improved clinical outcomes, specifically higher GCS scores and fewer ventilator days. These findings reinforce the well-recognized benefits of helmet use across all age groups. Despite this, helmet compliance among e-bike riders remains low nationwide. Future research should examine long-term trends in e-bike incidents, hospital outcomes, and the impact of additional protective measures and regulatory policies. Continued investigation in this field is needed to identify injury patterns and guide public health initiatives aimed at enhancing rider safety.