*Strengths and Limitations*

Due to the high number of cases and the study period of almost two decades, our study has a high level of representativeness.

This study has several limitations. It is a retrospective analysis.

Patients who died in the prehospital setting are not included in the TraumaRegister DGU®. Data from patients who were admitted to the hospital without activation of the trauma team are not captured by the TraumaRegister DGU®. Another limitation of this study is that treatment restrictions, for example due to a living will, were not recorded. The participation of hospitals in the TraumaRegister DGU® is voluntary [15].

#### **5. Conclusions**

There is a noticeable increase in the number of motorcycle and bicycle accidents during the DST from standard to summer time. Our results should be understood as a tendency, since various influencing factors, such as times of day and weather, were not taken into account.

**Author Contributions:** Conceptualization, A.N., R.R., R.L.; methodology, A.N., R.R., R.L.; software, R.L.; validation, A.N., R.R., R.L.; formal analysis, A.N., R.R., R.L.; investigation, A.N., R.R., R.L.; resources, A.N., R.R., R.L.; data curation, R.L.; writing—original draft preparation, A.N., C.S.; writing—review and editing, A.N., C.S., R.L., M.D., T.O., B.B., V.W.; visualization, A.N.; supervision, M.D.; project administration, A.N., R.R., C.S., T.O.; funding acquisition, A.N., M.D. All authors have read and agreed to the published version of the manuscript.

**Funding:** The APC was funded by the Open Access Publication Fund of the University of Duisburg-Essen. A grant no. is not applicable.

**Institutional Review Board Statement:** The study was conducted according to the guidelines of the Declaration of Helsinki and is approved by the Ärztekammer Nordrhein (no. 310/2018). The present study complies with the publication guideline of the TR-DGU and is registered under the TR-DGU project ID 2018-047.

**Informed Consent Statement:** Not applicable.

**Data Availability Statement:** Data are available from andre.nohl@bg-klinikum-duisburg.de.

**Conflicts of Interest:** The authors declare no conflict of interest The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

#### **Abbreviations**

Abbreviations


#### **References**

