Clinical and patient-reported outcomes for bicycle and micro-mobility accidents: A prospective study with 12-month injury follow-up.

Abstract

There has been a huge increase in bicycle and micromobility device use in Europe but the systematic collection of accident and injury data including patient-reported outcome measures is lacking. Prospective registration of accidents from bicycle-and micro-mobility usage within Agder County, Norway from 1st June 2022-30 th September 2023. Study sites had posters, folders and business cards with project QR codes linked to accident questionnaires covering helmet use, type of bicycle, type of accident and retrospective pre-injury EQ-5D-5L. Within 5 days, the injured were telephoned and asked for consent to the collection of clinical data covering injury and treatment, and EQ-5D-5L follow-up at 3, 6, and 12 months. The Abbreviated Injury Scale (AIS) and New Injury Severity Score (NISS) were used for injury severity/site and overall severity, respectively. Multi-trauma followed the Newcastle definition. Multiple injury was defined as > 1 affected AIS body chapter. Of 460 eligible patients, 317 (68%) completed the baseline EQ-5D-5L. The mean age was 37 yrs and 39% were female. Median (IQR) NISS was 4 (1-5), 38% had multiple (2-5) injuries, 1% were multi-trauma according to the Newcastle definition, AIS upper extremity injuries affected over 60%. 78% had worn a helmet, 25% rode an electric bicycle, and 75% of accidents did not involve other road users. Median (IQR) recovery was 37 (14-61) days; 11 (3%) had not fully recovered at 12 months. At 12 months both EQ-5D-5L index (p = 0.001) and EQ VAS (p = 0.001) scores exceeded those at pre-injury, and the only significant difference across demographic and clinical strata was observed for injury type: those with multiple injuries had lower improvements in EQ-5D-5L index scores compared to those with single injuries (p = 0.034). Within this sample of bicycle and micromobility accidents that is broadly representative for Norway, the great majority of injuries were to the head and extremities, with fast recovery to pre-accident self-reported health-related quality of life. Given the high number of bicycle accidents and continued increase in bicycle and e-scooter use, further accident and injury monitoring is recommended.