Hospitalization Trends of Fractures Presenting to the Emergency Room From 2009 to 2021

Abstract

Purpose
 Assessing trends in hospitalization rates due to fractures may be used as an indirect epidemiologic metric to predict future patient volumes, staffing needs, revenue, expenditures, and allocation of resources. The aim of this study is to analyze the trend of hospitalizations for patients who presented to Emergency Departments (EDs) with fractures from 2009 to 2021.
 Methods
 We extracted data from the National Electronic Injury Surveillance System (NEISS) database. All consecutive patients with a primary injury of fracture in the years 2009 to 2021 were eligible for inclusion in this study. The Cochran-Armitage test was used to assess the trend in fracture-related hospitalization rates over the years studied.
 Results
 This study showed a significant increase in hospitalizations due to fractures from 2009 to 2021 (p<0.001). This increase in hospitalizations was observed consistently across various factors, including sex, fracture location, age categories, and the pre- and post- COVID-19 pandemic period. From 2009 to 2021, the mean age of patients presenting to EDs was increased from 34 to 40 (p<0.001) and the percentage of women increased from 45% to 48%. There was a significant increase in hospitalizations across five fracture regions including the upper trunk, proximal and distal upper extremity, and proximal and distal lower extremity.
 Conclusions
 Our findings show hospitalization trends due to fractures have been increasing across the U.S. While reasons for this increased trend are multifactorial, increased utilization of urgent care for less severe injuries may be artificially driving these trends.