258. Epidemiological trends associated with football-related spine injuries

Abstract

<h3>BACKGROUND CONTEXT</h3> Despite the health-related consequences associated with American football, it remains a ubiquitous part of American athletics. This study investigates trends in football-related spine injuries, focusing on the regional distribution of spine injuries across age demographics. We specifically focus on vulnerabilities in pediatric and adolescent populations, which constitute an overwhelming majority of emergency department (ED) cases. <h3>PURPOSE</h3> To identify age-related trends of football-related spine injuries presenting to the ED and also distinguish independent drivers of hospital admission following presentation for these injuries. <h3>STUDY DESIGN/SETTING</h3> NEISS database is a nationally representative, probability sample of hospital emergency departments (EDs) in the United States. <h3>PATIENT SAMPLE</h3> A total of 7,196 weighted cases of spinal injury associated with playing football were observed in the NEISS database. <h3>OUTCOME MEASURES</h3> National incidence and risk factors for admission to the ED versus discharge following spine fracture or spinal nerve injury associated with playing football. <h3>METHODS</h3> The National Electronic Injury Surveillance System (NEISS) database was queried for annual estimates of spinal injury sustained while playing football that presented to emergency departments across the United States between 2010 and 2019. Data regarding the nature and location of the injury were obtained. Patients' hospital dispositions were tracked as either discharged from ED or admission/transfer to another hospital. A multivariable logistic regression analysis was conducted to identify which factors among the available data were independently associated with admission to the hospital/transfer to another care facility versus discharge from the ED. <h3>RESULTS</h3> A total of 61.60% of football injury patients experienced vertebral fractures, while the other 38.40% of patients experienced spinal nerve injury. 23.29% of all injuries involved the neck/cervical spine, 39.56% affected the upper thoracic spine, and 37.16% involved the lower trunk/lumbar spine. Between ages 9-14, the majority of spinal injury cases involved the thoracic spine (54.86%), whereas ages 15-20 and among those 21 and older, the most common region of spinal injury was the lumbar spine (37.87% & 47.99%, respectively). Age cohort had a significant effect on the region of the spine that was injured (P<0.0001). Of patients who were injured while playing football, 73.2% were directly discharged from the ED, while the other 26.83% required either admission or transfer. Independent predictors of hospital admission/transfer to another hospital following a spinal injury related to playing football included a patient's age between 15 and 20 (OR: 1.960; 95% CI: 1.700 to 2.262) when compared to adults, Black/African American race (OR: 1.537; 95% CI: 1.301 to 1.814) when compared to White race, injury of the cervical spine (OR: 6.853; 95% CI: 5.855 to 7.996) or thoracic spine (OR: 2.810; 95% CI: 2.418 to 3.271) compared to the lumbar spine. <h3>CONCLUSIONS</h3> The pediatric population is more susceptible to injuries involving the thoracic spine while the adolescent and adult populations more commonly sustain injuries afflicting the lumbar spine. In addition to these age and anatomic trends, we found late adolescent age (15-20 years), Black/African American race, cervical spine injuries, and thoracic spine injuries to be independently associated with higher odds of hospital admission. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.