Incidence Of Head Injuries Research Articles

Pathophysiological to Clinical Aspects of Head Injury: Narrative Literature Review

Head injury is a change in brain function or brain pathology, caused by external forces on the head. Changes in brain function consist of any period of loss or loss of consciousness, anterograde or retrograde amnesia, neurological deficits, or mental changes following a head injury. A study reported that the highest incidence of head injury was in the Americas, which was 1299 cases per 100,000 population, followed by Europe, which was 1012 cases per 100,000 population. The lowest incidence of head injury occurred on the African continent, which was 801 cases per 100,000 population. Based on these data, the overall incidence of head injuries in the world is 939 cases per 100,000 population with most of them being mild head injuries (55.9 million cases per year) and 5.28 million people experiencing severe head injuries.

Endotheliopathy is Associated with a 24-hour Fibrinolysis Phenotype Described by Low TEG Lysis and High D-Dimer after Trauma: a Secondary Analysis of the PROPPR Study.

Determine associations between biomarkers of endotheliopathy, 24-hour fibrinolysis phenotypes and clinical outcomes after trauma. The vascular endothelium is a critical regulator of hemostasis and organ function. The relationship between markers of endotheliopathy and fibrinolysis following trauma has not been evaluated. We performed a secondary analysis of prospectively collected biomarker data in the Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) randomized controlled trial. We stratified subjects by 24-hour thromboelastography (TEG) percent clot lysis (LY30) and plasma D-dimer (DD) levels and evaluated differences in endotheliopathy biomarkers and clinical outcomes between subjects with one of four 24-hour fibrinolysis phenotypes: LY30 0.9-2.9% (LY30norm), LY30 >2.9% (LY30high), LY30 <0.9% and low DD (LY30low+DDlow), and LY30 <0.9% and high DD (LY30low+DDhigh). The analysis included 168 subjects with LY30norm, 32 with LY30high, 147 with LY30low+DDlow and 124 with LY30low+DDhigh. LY30low+DDhigh subjects had greater injury severity and a higher incidence of severe head injury, multiorgan failure (MOF), and mortality than the other phenotypes. All endotheliopathy biomarkers were significantly higher in the LY30low+DDhigh phenotype. Adjusting for injury severity, mechanism and head trauma, 24-hour angiopoietin-2 and soluble thrombomodulin were independently associated with the LY30low+DDhigh phenotype. Both endothelial biomarkers were discriminating for MOF. Subjects with thrombomodulin level >9.5 ng/mL and angiopoietin-2 level >3.6 ng/mL accounted for 64% of subjects who developed MOF. In a multicenter trauma cohort, subjects with a fibrinolysis phenotype characterized by low TEG lysis and elevated DD 24 hours after injury have significantly worse endotheliopathy and clinical outcomes. Our findings support mechanistic evaluations of the role of the endothelium in fibrinolysis dysregulation that may drive late-stage organ injury.

472 Effects of Recurrent Mild Traumatic Brain Injuries on Incidence, Severity, and Recovery of Concussion in Young Student-Athletes

INTRODUCTION: Currently, it is known that athletes who sustain recurrent concussions are at an increased risk for long-term neurological consequences. Moreover, in the short term, athletes with a history of concussions are significantly more likely to sustain future concussions. Although the increased incidence of mTBI among athletes with a history of concussions has been well documented, there is less consensus about how recurrent concussions affect the severity and recovery of the next head trauma. METHODS: Data from 11 563 ImPACT baseline evaluations of US student-athletes aged 12 to 22 years were separated into 2 cohorts: subjects reporting 2 or more previous concussions (PC; n = 976 baseline evaluations) at baseline and a control group reporting zero previous concussions (CT; n = 7743 baseline evaluations). Subjects reporting 1 prior concussion were excluded. Differences in SND incidence, severity, and recovery between the 2 cohorts were assessed using chi-squared tests, t tests, survival analyses, and multivariate regressions. RESULTS: The PC cohort had a higher incidence of head injury leading to ImPACT (436.7 per 1000 person-years vs 194.4 per 1000 person-years, P &lt; .0001) and a higher incidence of SND (140.4 vs 71.8, P &lt; .0001) than controls. However, the Severity Index (SI) demonstrated that SND severity was lower in the PC group (7.55 vs 8.59, P = .04). Adjusted analyses similarly demonstrated that the PC cohort had increased SND incidence (odds ratio = 1.93; 95% CI, 1.61 to 2.31; P &lt; .0001), decreased SI (β = −1.37; 95% CI, −2.40 to −0.34; P = .009), and equivalent recovery (hazard ratio = 0.98; 95% CI, 0.76 to 1.72; P = .90). CONCLUSION: Participants with a history of concussion have a higher incidence of SND but present with lower severity SND, which may be a result of increased concussion education or symptom awareness. Recurrent concussion has no significant impact on acute neurocognitive recovery. Together, these results provide evidence against the supposition that a history of concussion increases the severity of future SND.

An epidemiological study of fatal head injury cases in a sub urban region of Chennai: A prospective study of 350 autopsy cases

It is a prospective study of 350 fatal head injury cases brought during the study period extending from Jan’2016 to Dec’2017 admitted and treated in our tertiary health care center. The incidence of fatal head injury is growing with increasing number of high speed vehicle, more mobility of the public and urbanization. In short, it is the single most common cause of morbidity and mortality in emergency wards. Maximum cases were seen in the age range of 21-30yrs, 89 cases (25.42%). Maximum cases were seen amongst males, 281 cases, 80%. The commonest causes of fatal head injuries are Road Traffic Accident (RTA) cases. Other important causes of fatal head injuries are fall from height, assault &amp; railway accidents. External head injuries were mainly seen on frontal and parietal regions. Amongst the scalp injuries lacerations were very common seen in 149 cases, 35.90%. Skull bone fractures were frequently seen in fatal head injury cases. Presence of skull bone fractures are associated more frequently with fatal complications. Though linear fractures are common in general we observed the comminuted fractures as the commonest type of skull fractures in fatal head injury cases, seen in 77 cases, (57.03%). Depressed fractures were less common in fatal cases. Involvement of cranial fssa was seen in 113 cases. Linear type of fractures both transverse and horizontal type was more common seen in 71 coases amongst the 113 cases of cranial fossa involvement i.e. 62.83%. Involvement of middle cranial fossa was high seen in 47 cases of the 113 cases i.e. (41.59%). Presence of comminuted skull bone fractures is associated with higher rate of mortality.

Penggunaan Antikejang Pada Cedera Kepala: Tinjauan Sistematis

Brain injury can occur due to direct head impact and injury due to brain tissue damage such as hypotension, hypoxia, acidosis and edema. Brain injury will trigger an inflammatory process that can lead to post-trauma seizures. The use of anti- epileptic drugs is intended as a seizure prophylaxis so that it can reduce the incidence of seizures in the early phase of injury. Quantify the effectivity of anti seizure usage on post traumatic seizure accident. The method used in this paper is a relevant systematic review from various references and focuses on the use of analgesics for the management of seizures due to brain injury. The literature search used PubMed and found 7 literature that met the criteria. Consists of 1 RCT study and 6 observational studies. Prophylactic therapy in the incidence of head injury is effective in preventing PTS. The use of anti seizure can be given to patients with moderate or severe TBI and can be given less than 12 hours after injury to prevent seizures. Prophylactic therapy is only recommended for 7 days after head injury. Anti seizure drug which is often used as a prophylactic agent are phenytoin and levetiracetam. Lacosamide is recommended for users with refractory status epilepticus. Levetiracetam has fewer side effects than phenytoin and lacosamide, so the use of this drug is preferable to use.Using Anti seizure in cases of post-traumatic brain injury (TBI) or post traumatic seizure (PTS) is behoof as a seizure prophylactic attempt by using recommendation less than eight days because OAE has been shown several side effects, include increasing mortality. Especially for using phenytoin and lacosamide, it is necessary to monitor

Analytical report on post traumatic hydrocephalus

Post-traumatic hydrocephalus (PTH) is a field and disorder less explored in neurosurgery though we see many cases. The commonest causes in our set up includes head injury for which people have undergone decompressive craniectomies, severe head injuries with raised ICP. We did a clinical analysis on 23 cases in a period of 3 years duration from 2018 -2021. We did Evd in few cases for emergency purposes when there was decerebration and we went ahead with VP shunt in all the patients who had gross ventricular dilatation. We have projected our analytical report in these cases. METHODS A retrospective study was conducted in the Department of Neurosurgery in Sri Ramachandra medical college. The clinical outcome of patients diagnosed with PTH was studied. These cases were treated by surgery. The stastical analysis along with cause of the hydrocephalus with the outcome in pre and postoperative period were studied. RESULTS Among the 23 patients studied 82% were males. Road traffic accident was the main cause of injury. The other main cause was a fall from height. Assault was another reason for head injuries which we recorded. We found all road traffic accidents were only because of bike riders either pillion or the people driving the vehicle. . Craniotomy was done in 50 % of the patients, 90 % of the patients recovered who had a gcs of 13 to 7. People with gcs lss than 7 were intubated recovery rate was 7.5 %. . There was 100%mortality because of primary head injury in all the patients who had brain stem contusions with dilated pupil. CONCLUSIONS Trauma to head and who were operated had the highest incidence of post tramatic head injury. Smaller the decompressive craniectomies had symptomatic post traumatic head ache with post traumatic hydrocephalus.. CT scan of the brain is considered the choice of investigation toearly diagnose PTH.we even analysed the ct scan and found when there was periventricular lucency the patient outcome after VP shunting is good. KEY WORDS Hydrocephalus, Head Injury, Trauma

Factors associated with head injury among survivors of motorcycle crashes: a case-control study in northern Ghana.

the increasing use of motorcycles in northern Ghana is associated with a high incidence of motorcycle crashes and resultant head injuries. This study sought to determine factors associated with head injuries among survivors of motorcycle crashes in northern Ghana. a prospective unmatched case-control study was conducted at the Tamale Teaching Hospital (TTH). A total of 326 cases (victims who suffered a head injury with or without other injuries) and 294 controls (persons who suffered various injuries except for head injury) from motorcycle crashes were consecutively sampled at TTH from December 15, 2019, to May 15, 2020. A semi-structured questionnaire was used to interview patients in addition to medical records review. Factors associated with head injury were examined using multivariable logistic regression at p<0.05 and a 95% confidence interval. the prevalence of head injury was 53.03% among of 660 survivors of motorcycle crashes. The majority of the patients were young males aged 15-44 years. The rate of helmet use was lower in cases (12.88%) than in controls (57.82%) (p<0.001). Factors associated with head injury were not wearing helmet (AOR= 9.80, 95% CI: 6.22, 15.43), male (AOR=1.75, 95% CI: 1.07, 2.85), student (AOR=0.38, 95% CI: 0.16, 0.91), and alcohol use within 24 hours (AOR=0.17, 95% CI: 0.04, 0.70). non-use of helmet and male gender significantly increased the risk of head injury risk in this study. Alcohol use and being a student were associated with lower odds of head injuries. Motorcycle safety efforts in the study area should emphasize helmet promotion.

Biomecânica e traumatologia no râguebi

Rugby is one of the team sports with the highest incidence rate of injuries per exposure time. These mainly occur in specific sport movements such as the tackle, ruck, or maul. Therefore, it is important to understand the sports’ specificities and biomechanics and link them with its risk and injury type. The most common reported injuries are musculotendinous and ligament ruptures of the lower limbs, however, we highlight the important incidence of severe head and neck injuries, like cerebral concussion and cervical spine fractures. It is essential to gather data that enable us to characterize the risk and specify of each movement performed by the athlete, to make more effective programs on injury-prevention and rehabilitation of injured athletes, always focusing on their full recovery and reinjure risk reduction.

Incidence of Cranial Nerve affection afteracute head injury: clinical and surgical outcome

Incidence of Cranial Nerve affection afteracute head injury: clinical and surgical outcome

Camel-Related Head Injury in a High-Income Developing Country.

Injury caused by large animals varies according to the regional distribution of the animals and their relationship to humans. Camels are usually friendly to humans; however, occasionally they become very hostile, especially in rutting season. Most in-hospital trauma deaths are related to head injury. Very few studies in the literature have discussed camel-related head injuries. We aimed to study the incidence, mechanism of injury, types, and outcome of camel-related head injury in a high-income developing country to give recommendations on preventive measures. We retrospectively collected data from all patients who were admitted to Al Ain Hospital with a camel-related head injury from January 1, 2015, to January 1, 2021. Data collected included demography, mechanism of injury, anatomical location, severity of the injury, associated injuries, and management. The patients were followed up during their hospital stay to record the length of hospital stay, complications, and outcome. During the study period, 98 patients were admitted to Al Ain Hospital with camel-related injury. Thirty-nine (39.8%) of the admitted patients with a camel-related injury sustained a head injury; a camel-related head injury was more common during August (23.1%). Thirty-four (87.2%) patients were camel caregivers. Thirty-three patients (84.6%) were injured on farms. Seven patients suffered an intracranial hemorrhage, and six (85.7%) of them had a history of fall from a camel. Glasgow Coma Score was significantly correlated to the severity of head injury measured by Abbreviated Injury Severity of the head (P = 0.006, Spearman's correlation). One patient died during the study period after having decompressive craniectomy for subdural hemorrhage (overall mortality 2.6%). The majority of camel-related head injury occurred in camel caregivers at camel farms and can be considered a work-related injury. Careful handling of camels, especially during the summertime can reduce the toll of camel-related head injury and its serious consequences. None of the injured patients was wearing a helmet at the time of injury. Legislation for compulsory helmet usage by camel caregivers at farms may decrease the incidence of head injuries in those patients.

Tumour Necrosis Factor Alpha Serum Levels and its Gene Polymorphism 850 C/T (rs1799724) as Prognostic Markers of Traumatic Brain Injury Outcome

Introduction: Road traffic accidents have been responsible for the high incidence of head injuries. In a study from India, it was reported that there were 150 Traumatic Brain Injury (TBI) cases per 1,00,000 population, out of which 20 succumbed to death. In the repair process of TBI many chemicals play a role, of which, Tumour Necrosis Factor alpha (TNF-a) is important as TNF-a was shown to possess both neurotoxic and neuroprotective activity. Aim: To evaluate the serum levels of TNF-a and its functional polymorphism in TBI patients and assessing the outcome. Materials and Methods: The prospective cohort observational study was conducted in the Department of Genetics and Molecular Medicine, Kamineni Hospitals, Hyderabad, Telangana, India, from June 2008 to May 2012. It included 126 patients of both sexes with severe and moderate head injuries based on Glasgow Coma Scale (GCS) scores. A 3 mL of plain/Ethylenediaminetetraacetic acid (EDTA) blood sample was drawn from individuals immediately after admission, which was used for serum TNF-a assessment and DNA isolation for TNF-a genotype analysis. The TNF-a levels were measured by Enzyme Linked Immunosorbent Assay (ELISA) using KRISHGEN Biosystems (Catalog No. KB 100-HTNF a) kit. Outcome assessment was done based on Glasgow Outcome Scale (GOS). Statistical analysis was accomplished by Open Epi version 3.01 software. Odd’s Ratio (OR) were used to calculate risk of good/bad outcome with 95% confidence interval and results with a p&lt;0.05 were considered statistically significant. Results: A total of 126 subjects of Indian origin were enrolled in this study. The mean age of the subjects was 36.7±12.97 years. Out of the 126 patients, 46.8% (59) had multiple lesions. The patients with &lt;40 pg/mL (as per the kit specifications) TNF-a levels were 67.50% (85/126), while those with &gt;40 pg/L were 32.50% (41/126). The most common genotype found in the TBI patients was TT with a frequency of 60.3% (76/126), followed by CT with a frequency of 16.6% (21/126) and CC with a frequency of 23% (29/126). When genotype and TNF-a serum levels were studied together, it was seen that low TNF-a level (11-40 pg/mL) was associated with C allele and CC genotype, while those with TT genotype had high TNF-a level (&gt;40 pg/mL) when compared with other genotypes (CC, CT) and this was found to be statistically significant with an OR=3.4064, (95% CI= 1.8426 to 6.2975), p=0.0001. Higher percentage of death and disability was seen in patients with TT genotype while CC genotype showed good recovery at six months with OR=3.6441 (95% CI=1.911 to 6.946), p=0.0001. This suggests that T allele of TNF-a C850T polymorphism has a 3.6 fold higher risk of bad outcome in patients with TBI. Conclusion: The C allele and CC genotype of rs1799724 polymorphism was associated with positive outcome at three to six months. Thus, evaluating TNF-a levels and evaluating the genotype of rs1799724 polymorphism at admission, can be taken as prognostic marker. It can also be used as a target for therapeutic intervention.

Gambaran Kualitas Hidup Pasien Pasca Mengalami Cedera Kepala: Literature Review

&#x0D; Head injury is a type of trauma that is commonly found in emergency departements, this is evidence by the large number of deaths resulting from the incidence of head injuries. if the patient survives and they&#x0D; will have physiological or anatomical disorders that affect to the quality of life. The purpose of this&#x0D; literature study is to find out the quality of life of patients after suffering a head injury. The method&#x0D; used is a literature study obtained from scientific reseach article that searches in accordance with the&#x0D; inclusion criteria, start from 2015 up to 2019 using Google Scholar,Science Direct, and Pubmed. The&#x0D; keyword used are Quality of life, Head Injury. Based on 7 research articles, it was found that 6 out 7 articles stated that there was a decrease in quality of life in post-injury patients with duration of 3, 6, and 12 months, evaluation quality of life the domain of assessment of quality of life that experienced the most decrease was in the physical, psychological, social and cognitive domains, 1 research article stated that there was increase in quality of life after head injury. Based on result there was a decrease in quality of life in post-injury patients&#x0D;

Traumatic Brain Injury in the Elderly is common but is not as Bad as we Think! Exercise, not rest, can ensure faster recovery from post-concussion syndromes “Autobiographical case report”

Head injuries, medically known as Traumatic Brain Injuries (TBI) are a leading cause of seeking emergency medical care, hospitalization, long hospital stays, disabilities, rehabilitation services, case fatalities and socioeconomic losses in India. Head trauma is one of the common injuries in the old due to trivial falls, and its consequences need not be grievous always. As many of the elderly are on medication for hypertension, diabetes, and heart ailments and due to sudden rising from the bed, or even from the commode or Indian style of squatting plate develop giddiness and fall. Incidence of head injuries is rising all over the world but fortunately more than half of them is either mild or moderate amenable to management with good outcomes. They can sometimes be serious and fatal when left untreated. The epidemiology of TBI is still an enigma in the medical world due to inconsistency in the definition and classification and discrepancies in data collection. Glasgow Coma Scale (GCS) is a well-accepted tool to assess the seriousness at the first visit to stratify, monitor the prognosis, and recovery of brain functions in patients with traumatic brain injury. Seniors over the age of 60 years with head injury are generally considered to have a poor outcome. However, a recent large multicentric China epidemiologic study of minor head injury patients (GCS 13–15) reported over 90 % survival, few with minor consequences. Another large-scale retrospective study at a level II trauma centre in Florida from 2005 to 2008, too indicated that the outcome of elderly over 65 years old had a survival rate of over 80 %. I report my own autobiographical case of a closed head injury, with good outcome due to timely care and early initiation of aerobic exercise (waking &amp; tread meal) for recovery from concussion injury due to fall in washroom, with no major post-concussive symptoms.

Occupational vs. non-occupational equestrians: Differences in demographics and injury patterns

IntroductionNineteen million people participate in horseback riding activities in the US, and the horse industry employs more than 460,000 full-time workers. Emergency department data suggest young female amateurs and male professionals are most at risk of death from horse-related injuries. However, there has been no investigation into factors that may increase severe injury and mortality risk in these populations. This study investigates demographics and injury pattern differences between occupational and non-occupational horse-related injuries in the US. MethodsThe 2017 American College of Surgeons National Trauma Databank (ACS NTDB) was analyzed for horse-related injury using ICD 10 codes. Demographics, injury data, protective device use, and hospital procedures were analyzed. Occupational versus non-occupational injuries based on incident location (farm, sports, recreational, residential) were compared using ANOVA or Pearson's Chi-squared test. ResultsOf 3911 incidents, the most common injury mechanism was falling from the horse, but occupational and non-occupational farm injuries showed higher incidence of being struck by a horse. One-third required surgery. Upper extremity injuries were most common. Occupational injuries more often affected upper extremities of working age, minority males with commercial insurance. Non-occupational injuries most often affected heads of women at the extremes of age. Helmet use was higher in occupational, non-occupational sports, and non-occupational recreation injuries, and severe head injury incidence was decreased in these groups. Complications and discharge dispositions were not different across groups. ConclusionsIn the largest trauma center study to date, we have shown equine-related trauma to be common and affect a predictable demographic that may permit injury prevention initiatives. Helmets may reduce severe head injury, but the efficacy of protective clothing remains to be validated.

Incidence of pediatric injury visits decreased while trauma surgeries remained stable during the first and second waves of the COVID-19 pandemic in Finland: a register-based study

IntroductionThe COVID-19 pandemic has reduced pediatric emergency department (ED) visits and surgeries. This study evaluates the incidence of pediatric trauma ED visits and surgeries in Finland during the first and...

Comparison of head impact frequency and magnitude in youth tackle football and ice hockey

Repetitive head impacts are a growing concern for youth and adolescent contact sport athletes as they have been linked to long term negative brain health outcomes. Of all contact sports, tackle football and ice hockey have been reported to have the highest incidence of head or brain injury however, each sporting environment is unique with distinct rules and regulations regarding contact and collisions. The purpose of this research was to measure and compare the head impact frequency and estimated magnitude of brain tissue strain, amongst youth tackle football and ice hockey players during game play. Head impact frequency was documented by video analysis of youth tackle football and ice hockey game play. Impact magnitude was determined through physical laboratory reconstructions and finite element modelling to estimate brain tissue strains. Tackle football demonstrated significantly higher impact frequency (P < 0.01) and magnitude of estimated brain tissue strains (P < 0.01) compared to ice hockey. A significantly higher number of higher strain head impacts were documented in tackle football when compared to ice hockey (P < 0.01). These differences suggest that youth football players may experience increased frequency and magnitude of estimated brain tissue strains in comparison to youth hockey.

Trauma, alcohol and drugs misuse in car and motorcycle drivers: a prevalence study in a level one trauma center

Alcohol and drugs misuse represents an important social problem. There is no agreement about influence of ethanol and drugs on trauma severity and clinical course. The aim of this study was to investigate the impact of alcohol and drugs abuse on road related trauma managed to our Level I Trauma Center. Data of 1067 car or motorcycle drivers consecutively admitted in a 5 years period were retrospectively analyzed. The sample was divided into two groups: patients with alcohol and/or drugs misuse and patients without detectable plasmatic levels or not screened because no clinical suspicion of these substance. Demographic data, mechanism of trauma, severity of injury, daily and season time of trauma distribution, alcohol and drugs levels and outcomes were retrieved. Alcohol or drugs misuse were detected in 242 patients. Heavy alcohols levels were the 62.3%. Among drugs cannabis was the most detected substance. These patients were significantly younger than the overall study population (p = 0.011), with a higher ISS (p = 0.012) a lower RTS (p = 0.047), a lower GCS (p = 0.005) and an higher head injuries severity (p = 0.030). Regarding time distribution, Saturday was the day with the highest percentage of trauma associated with substance misuse (21%). Alcohol/drugs misuse plays a very important role in the epidemiology of road related trauma. Despite the higher severity of trauma scores and the higher incidence of severe head injuries in patients with alcohol or drugs consumption, there were no effects of this substances on mortality of injured patients involved in road crashes.

Ophthalmic manifestations in head injury- A prospective study

The eye because of its location in the head and its proximity and neuronal connection with the brain, makes it more vulnerable in head injuries. An increase in the affordability and the attitude of younger generation has lead to the increased incidence of head injuries. Most of the times the ophthalmic manifestations are missed in early stages, where life saving assures the prime importance. This results in grave ocular complications when the patient survives.Various patterns of ophthalmic manifestations following head injury are studied. The grave situations are explored and importance of safety measures may be emphasized. All patients who sustained head injury with ophthalmic manifestations were enrolled in this study. They were subjected to thorough clinical evaluation, tests for visual acuity, color vision, examination with slit lamp, ophthalmoscope, ultrasound b scan, gonioscopy and various imaging techniques, other specialty opinion was also obtained whenever required. Distribution of cases according to the age, sex, mode of injury, laterality of the eyes was studied. Various ophthalmic presentations associated involvement of the orbital walls and cranial nerves were analyzed. Visual acuity at the time of presentation was correlated.The common mode of head injury which had considerable morbidity was found to be Road traffic accident. Precautionary measures should be initiated that may decrease these kinds of morbidities. These patients should be properly evaluated, monitored and managed.

Pediatric injuries related to electric scooter use: a national database review.

Electric scooter (e-scooter) use and resulting injuries have grown exponentially since expansion into ridesharing in 2017. No study has described pediatric e-scooter injuries and focused on their impact in an adolescent cohort. Our primary purpose was to describe the epidemiology of admitted pediatric e-scooter injuries and compare them with existing literature on adults. We queried the National Electronic Injury Surveillance System for e-scooter injuries between 2015 and 2019 in patients 0-18 years old. Injuries caused by an e-scooter to a nonrider were removed. Patients admitted to the hospital were analyzed and weighted national estimates were calculated. A P value of <0.05 was considered significant. Nine hundred and two pediatric patients were treated for an e-scooter injury at an emergency department (ED) between 2015 and 2019. Among those admitted (n = 47), 72.3% were men, and the average age at injury was 11.3 years. Among all injuries (n = 56), the most common diagnosis was fracture (24/56, 42.9%). The 19% (9/47) of patients that experienced polytrauma were significantly older than those with single injuries (P < 0.001). ED admissions grew by 616% from 2017 to 2018. Children experience a greater rate of fractures and polytrauma from e-scooters compared to adults, but fewer facial injuries despite a similar rate of head trauma. The incidence of pediatric head injuries indicates a lack of helmet use similar to adults. Lawmakers should consider bolstering e-scooter regulations to decrease pediatric injuries.

Head and Neck Injuries and Electronic Scooter Use in the United States.

To quantify electric scooter injuries encountered in United States emergency departments, focusing on the head and neck, to understand the safety impact of these scooters to improve safe usage. Retrospective cross-sectional study from January 2009 to December 2019 of patients presenting to United States emergency departments with electric scooter injuries collected from a national database. About 2,823 cases of injuries were related to electric scooter use from January 2009 to December 2019. Stratified weighted counts and incidence rates were estimated for injury characteristics. Piecewise linear regression quantified the yearly change in incidence of injuries before and after introduction of rideshare programs. The estimated national total of electric scooter cases from 2009 to 2019 was 103,943 (95% CI: 79,650-128,237). Incidence grew in 2019 to 8.63 cases per 100,000 person-years from 4.46 in 2018 to 2.42 in 2017. Head and neck injuries represented 28.5% of total injuries (weighted estimate=29,610). The most common age group of head and neck injuries before 2018 was ≤17 years, but injuries in 18- to 44-year-olds grew significantly to become the most injured group in 2018 to 2019 (P < .001). From 2009 to 2017, incidence of head and neck injuries fell by 0.02 cases per 100,000 person-years, but cases grew by 1.22 cases per 100,000 person-years post-2017 (P < .001). Injuries following the launch of rideshare electric scooter programs increased significantly, especially in patients 18 to 44 years of age. Head and neck injuries represent many of these injuries. User safety education must be addressed to prevent injury as programs become more pervasive in the United States. 2 Laryngoscope, 131:E2784-E2789, 2021.