Intoxication is a Significant Risk Factor for Severe Craniomaxillofacial Injuries in Standing Electric Scooter Accidents

Purpose: Standing electric scooters are a relatively new mode of transportation that are becoming increasingly popular in large metropolitan areas. The purpose of this study was to characterize injury patterns and identify risk factors for craniomaxillofacial injuries in standing electric scooter accidents.

Methods: This retrospective cohort study used a Clinical Data Warehouse search engine to identify patients who sustained standing electric scooter accidents from 2017 to 2019 using the International Classification of Diseases 10^th revision codes. Predictors including patient demographics, presence of intoxication, helmet use, mechanism of injury, and other noncraniomaxillofacial injuries sustained at the time of standing electric scooter injury were identified. Patients were grouped as per the presence or absence of craniomaxillofacial injuries so that risk factors could be identified for craniomaxillofacial injuries in standing electric scooter accidents. Logistic regression analysis was performed to identify potential risk factors and association for craniomaxillofacial injuries.

Results: The sample was composed of 165 patients with a mean age of 30.3 years and 73.9% were men. Of them, 38 (23.0%) sustained craniomaxillofacial trauma. They were ten times more likely to have been intoxicated than those who did not have craniomaxillofacial injuries (4.7 vs 52.6%). Concomitant injuries of the extremities and the craniomaxillofacial region were rare indicating that in many cases the arms and legs were not outstretched to "break the fall." The high numbers of mandibular fractures to the condylar, subcondylar, and symphyseal regions (23.8, 33.3, and 28.6%, respectively), Le Fort fractures (18.4%), and frontal sinus fractures (15.8%) indicate that falls in the anterior-posterior direction occur with the main point of impact occurring at the chin, midface, and forehead.

Conclusions: Intoxication may inhibit or depress protective reflexes that leave the face and head vulnerable during standing electric scooter accidents.