Epidemiology of mountain bike-related injury presentations to emergency departments: A 15-year retrospective analysis.

OBJECTIVES: To determine the epidemiology of mountain bike (MTB)-related presentations to public hospital emergency departments (ED) in Tasmania, Australia, pre- and post-development of purpose-built MTB trails. METHODS: Retrospective analysis of presentations to Tasmanian public hospital EDs pre- and post-MTB trail development in 2015 (total period: 1st January 2010-31 st December 2024). MTB-related injuries were determined from hospital medical records. Epidemiological characteristics were prevalence, clinical urgency (Australasian Triage Scale [ATS] categories 1-5, most to least urgent), arrival mode (ambulance vs private transport), mortality, admission rate, seasonal variation, injury profile and patient demographics. RESULTS: For the total period, there were 6643 MTB-related presentations. Prevalence increased 3-fold post-trail development, 1.0-3.6/1000 ED presentations (n = 743-5900) with seasonal burden highest in summer. Clinical urgency increased 375% for ATS category 1 from 0.8 (0.8) mean (SD) to 3.8 (2.8) presentations/year, and 1343% for category 2 from 8.2 (4.0) to 118.3 (65.5) presentations/year. Ambulance arrivals increased 372% from 21.2 (3.6) to 100 (47.6) /year. Hospital admission rate increased 663% post-trail development, from 17.2 (7.4) to 131.3 (64.4) /year. All four deaths were post-trail development. Over the total period, 41.6% of MTB injuries were orthopaedic, soft tissue injuries 27.5%, open wounds 19.3%, and multiple major trauma was 1.8%. Upper extremities were the dominantly injured body region (51.1%). Injured males were more prevalent (pre- 80%, post- 85%). Age distribution widened (10-50 years pre-, 5-80 years post-). 10-14 year-olds had the highest presentations/year increase from 13.8 (7.0) to 118.8 (67.2)/year. CONCLUSIONS: Increased rates of ED presentations, clinical urgency, and increased arrival by ambulance was observed post purpose-built MTB trail development. This study provides epidemiological data to inform riders about the risks, guide injury prevention strategies and health resource allocation.