Abstract
BackgroundSports and recreational activities are an important cause of injury among children and youth, with sports-related traumatic brain injuries (TBIs) being of particular concern given the developing brain. This paper reports the characteristics of sport and recreation-related (SR) emergency department (ED) visits among school-age children and youth in a statewide population.MethodsThis study included all injury-related visits made to all North Carolina 24/7 acute-care civilian hospital-affiliated EDs by school-age youth, 5–18 years of age, during 2010–2014 (N = 918,662). Population estimates were based on US decennial census data. Poisson regression methods were used to estimate incidence rates and rate ratios.ResultsDuring the five-year period, there were 767,075 unintentional injury-related ED visits among school-age youth, of which 213,518 (27.8%) were identified as SR injuries. The average annual absolute number and incidence rate (IR) of SR ED visits among school-age youth was 42,704 and 2374.5 ED visits per 100,000 person-years (95% confidence interval [CI], 2364.4–2384.6), respectively. In comparison to other unintentional injuries among school-age youth, SR ED visits were more likely to be diagnosed with an injury to the upper extremity (Injury Proportion Ratio [IPR] = 1.28; 95% CI, 1.27–1.29), the lower extremity (IPR = 1.14; 95% CI, 1.13–1.15), and a TBI or other head/neck/facial injury (IPR = 1.12; 95% CI, 1.11–1.13).Among ED visits made by school-age youth, the leading cause of SR injury was sports/athletics played as a group or team. The leading cause of team sports/athletics injury was American tackle football among boys and soccer among girls. The proportion of ED visits diagnosed with a TBI varied by age and sex, with 15–18 year-olds and boys having the highest population-based rates.ConclusionsSports and recreational activities are an important component of a healthy lifestyle, but they are also a major source of injury morbidity among school-age youth. Physical activity interventions should take into account sex and age differences in SR injury risk.
Highlights
Sports and recreational activities are an important cause of injury among children and youth, with sports-related traumatic brain injuries (TBIs) being of particular concern given the developing brain
Children and youth bear a disproportionate burden of sports and recreation-related (SR) injuries, with an estimated twothirds of all medically attended SR injuries occurring among 5–24 year-olds (Centers for Disease Control and Prevention 2002; Conn et al 2003)
The three most common External Cause of Injury Code (E-code) categories observed among school-age children and youth 5–18 years of age was “Sports/athletics played as a group or team” (e.g. American tackle football, basketball, and soccer), “other outdoor recreational activities”, and “falls/struck by/against in sports”
Summary
This population-based descriptive epidemiologic study examined the incidence, circumstances, and characteristics of SR injuries in children and youth. If an individual patient visit contained the following two E-codes: E849.4 (place for recreation and sport) and E007.0 (American tackle football), ED visit was classified as being due to American tackle football. As NC DETECT collects up to eleven ICD-9-CM diagnosis codes per patient visit, the ED visit was classified as being due to a TBI if the visit contained a TBI diagnosis code in any position. The fall and spring seasons contained the highest proportion of ED visits for both SR and total unintentional injury-related ED visits, but SR ED visits exhibited greater seasonal trends, with more pronounced differences between fall/spring and winter/summer seasons. The three most common E-code categories observed among school-age children and youth 5–18 years of age was “Sports/athletics played as a group or team” (e.g. American tackle football, basketball, and soccer) , “other outdoor recreational activities” (e.g. outdoor activities such as roller-skating/skateboarding and snow/off-road vehicles), and “falls/struck by/against in sports”
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