Trauma Visits Relating to E-Bikes and Non-E-Bikes at a London University Hospital Emergency Department Between 2022 and 2025: A Retrospective Cohort Study.

BACKGROUND: Electric bicycle ("e-bike") use has increased rapidly in London and internationally. E-bike-related trauma ranges from minor injuries to major polytrauma, with a substantial long-term health care burden. Contemporary U.K. emergency department (ED) data comparing e-bike and conventional bicycle injuries remain limited. STUDY OBJECTIVES: To quantify trends in e-bike-related ED visits in a 3-year period and compare demographics, injury patterns, alcohol involvement, helmet use, and markers of clinical severity with non-e-bike cycling injuries. METHODS: We conducted a retrospective cohort study of ED visits between September 2022 and August 2025. Cycling-related visits were identified from the electronic patient record using predefined search terms and categorized as "e-bike" or "non-e-bike." Data collected included demographics, time of presentation, injury type, admission, operative management, and documented alcohol and helmet use. Comparative statistical analysis was carried out using "R" software. RESULTS: Among 5529 cycling-related visits, 564 (10%) involved e-bikes. The proportion attributable to e-bikes increased from 3.8% in year 1 to 16.0% in year 3 (p < 0.001). Compared with non-e-bike injuries, e-bike injuries were associated with an increased relative risk of head or neck injury (+41%) and lower limb injury (+33%) and a reduced risk of upper limb injury (-36%). Alcohol involvement was more frequent in e-bike cases (8.0% vs. 3.0%). Where documented, 81% of e-bike riders were not wearing helmets. A total of 17 e-bike patients (3%) required surgery. CONCLUSION: E-bike-related ED visits increased substantially in the study period and were associated with distinct injury patterns and modifiable risk factors. These findings support targeted injury prevention and public health interventions as e-bike use continues to rise.