Trends in Sports- and Recreation-Related Traumatic Brain Injuries Treated in US Emergency Departments

Abstract

Importance: Sports- and recreation-related traumatic brain injuries (SRR-TBIs) are a growing public health problem affecting persons of all ages in the United States. Objective: To describe the trends of SRR-TBIs treated in US emergency departments (EDs) from 2001 to 2012 and to identify which sports and recreational activities and demographic groups are at higher risk for these injuries. Design: Data on initial ED visits for an SRR-TBI from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) for 2001-2012 were analyzed. Setting: NEISS-AIP data are drawn from a nationally representative sample of hospital-based EDs. Participants: Cases of TBI were identified from approximately 500 000 annual initial visits for all causes and types of injuries treated in EDs captured by NEISS-AIP. Main Outcome Measure(s): Numbers and rates by age group, sex, and year were estimated. Aggregated numbers and percentages by discharge disposition were produced. Results: Approximately 3.42 million ED visits for an SRR-TBI occurred during 2001-2012. During this period, the rates of SRR-TBIs treated in US EDs significantly increased in both males and females regardless of age (all Ps < .001). For males, significant increases ranged from a low of 45.8% (ages 5-9) to a high of 139.8 % (ages 10-14), and for females, from 25.1% (ages 0-4) to 211.5% (ages 15-19) (all Ps < .001). Every year males had about twice the rates of SRR-TBIs than females. Approximately 70% of all SRR-TBIs were reported among persons aged 0 to 19 years. The largest number of SRR-TBIs among males occurred during bicycling, football, and basketball. Among females, the largest number of SRR-TBIs occurred during bicycling, playground activities, and horseback riding. Approximately 89% of males and 91% of females with an SRR-TBI were treated and released from EDs. Conclusion and Relevance: The rates of ED-treated SRR-TBIs increased during 2001-2012, affecting mainly persons aged 0 to 19 years and males in all age groups. Increases began to appear in 2004 for females and 2006 for males. Activities associated with the largest number of TBIs varied by sex and age. Reasons for the reported increases in ED visits are unknown but may be associated with increased awareness of TBI through increased media exposure and from campaigns, such as the Centers for Disease Control and Prevention’s Heads Up. Prevention efforts should be targeted by sports and recreational activity, age, and sex.

Pediatric sports-related traumatic brain injury in United States trauma centers

“…Previous studies have described the incidence of sports-related TBI in adult ED populations. 10,23,46 Similarly, a large study in the Pediatric Emergency Care Applied Research Network, conducted between 2004 and 2006, recently reported that the overall incidence of sports-related TBI was 1%, with significant variation by type of sports. 20 However, the characteristics of inpatient hospital LOS, complications, discharge, and mortality rates in a large, nationally representative cohort have yet to be described.…”

Using the public health model to address unintentional injuries and TBI: A perspective from the Centers for Disease Control and Prevention (CDC)

“…Sports and recreation-related concussions are serious injuries, with an estimated 325,000 children and teens treated in emergency departments for sports and recreation-related TBIs in 2012 (Coronado et al, 2015). That's just shy of 40 injuries every hour.…”

Adult sports-related traumatic brain injury in United States trauma centers

“…Previous studies have reported on the incidence of sports-related TBI in various ED populations. 10,17,39 However, the absence of inpatient and acute outcome data has precluded an analysis of hospital LOS, discharge disposition, and mortality rates after sports-related TBI. In the present analysis of an NTDB data set collected over a 10-year interval, we characterized the demographic profiles, hospital and ICU LOSs, medical complications, mortality rates, and discharge disposition across multiple broad categories of sports disciplines in adults admitted for sports-related TBI to Level I and Level II US trauma centers.…”