National Electronic Injury Surveillance System Research Articles

Risk Factors for Eye and Orbital Injuries Related to Electric Scooters and Off-Road Vehicles

ABSTRACT Purpose Electric scooters (e-scooters) have rapidly become a mainstream method of transportation in the U.S. but there is consequently limited data on their safety profile. This study evaluates ophthalmic injuries related to e-scooters compared to non-motorized scooters and off-road vehicles (ORV). Methods This retrospective study uses the National Electronic Injury Surveillance System (2014 to 2023). Ocular injury profiles associated with conventional scooters, e-scooters, and off-road vehicles were included. Results E-scooter ocular injuries rose by 1950% between 2014 and 2023. E-scooter riders were 4.3 times more likely to sustain orbital fractures and 2.7 times more likely to be hospitalized than non-motorized scooter riders. ORV and e-scooter riders had comparable injury and hospitalization patterns. Alcohol use and lack of helmet use were significant contributors to injury severity. Conclusions and Relevance Injury patterns and hospitalization rates in e-scooter accidents resemble those of ORV incidents. Findings highlight the need for public health interventions to reduce the burden of e-scooter-related injuries.

Co-use of cannabis and alcohol among adults and the burden of traumatic brain injury from fall-related events

ABSTRACT Background Co-use of cannabis and alcohol is an emerging trend that can exacerbate injury outcomes. While research has focused on younger age groups, there is a need to examine consequences associated with co-use among adults populations. Falls represent a leading cause of injury among older adults. Coupled with substance use, injuries associated with falls may be more severe. Objectives To examine the burden of fall-related head injury among adults who co-use cannabis and alcohol. Methods Emergency department data from the 2019–2022 National Electronic Injury Surveillance System were analyzed for fall-related head injuries associated with co-use of cannabis and alcohol among middle-aged and older adults aged 55–75. Results An annualized estimate of 545,276 fall-related injuries occurred. Patients who presented with co-use of cannabis and alcohol had the highest prevalence of TBI (PR 1.75; 95% CI 1.25–2.25) and CMF injuries (PR 1.70; 95% CI 1.38–2.03) when contrasted to the alcohol-only or cannabis-only groups. Conclusions Results highlight the burden of co-use of cannabis and alcohol on fall-related head injuries. Healthcare providers, policymakers, patients, and caregivers should be aware of these risks and prioritize targeted interventions to mitigate the impact on the health and safety of older individuals.

Comparative Study of Craniofacial Injuries in Skiing Versus Snowboarding: A NEISS Database Study

Introduction: Skiing and snowboarding are popular winter sports which are rising in popularity. There is a lack of detailed data in the literature regarding skiing and snowboarding head and neck injuries, especially the rate of concussions with helmet use. Methods: The authors queried the National Electronic Injury Surveillance System (NEISS) database to characterize patient demographics, injury types, subsite injured, and ED disposition associated with skiing and snowboarding-related head and neck injuries between 2009 and 2020 in the US. Results: An estimated 87,994 head and neck-related ski and snowboarding injuries were reported from 2011 to 2020 nationally. Ski-related and snowboard-related injuries comprised 51.9% and 48.1% of injuries, respectively. Ski-related injuries accounted for the majority of admissions (69.2%). Head injuries were the most common (68.3%), followed by injuries to the face (15.3%) and neck (12.2%). Concussions (57.7%) were the most common overall injury type and comprised 49.2% of admissions. Concussions were more common in snowboarding injuries (65.6% versus 50.3%, P<0.001), whereas lacerations (11.1% versus 14.4%), contusion/abrasions (6.7% versus 11.1%), and fractures (2.9% versus 7.0%) were more common in ski-related injuries. Cases with negative helmet status were associated with a greater proportion of concussion injuries (79.8% versus 70.9%, P<0.001). Conclusions: Patients presenting with skiing or snowboarding injuries require a thorough head and neck examination. A comprehensive history and physical should be performed with a focus on helmet use and evaluation for concussion, lacerations, and fractures. Helmet use is strongly recommended to prevent the risk of head injury. Level of Evidence: IV.

Frequency and mechanism of injury for unintentional paediatric femoral fractures associated with consumer products over a 10-year period in the USA.

Femoral shaft fractures tend to be rare among children; however, these injuries are the most common major paediatric injuries treated by orthopaedic surgeons. The purpose of this study is to characterise the demographics and mechanisms of femoral injury associated with consumer products in the age group treated with spica casting, children 6 months to 6 years, to identify areas for injury prevention. Data from 2012 to 2021 were obtained from the National Electronic Injury Surveillance System maintained by the Consumer Products Safety Commission, documenting emergency department visits for unintentional injuries associated with consumer products. Narrative descriptions were analysed to identify common factors in the injury events such as location, products and mechanisms of action. From 2012 to 2021, the estimated incidence of femur fractures was 23.5 cases per 100 000 children with no significant difference in yearly frequency. The most common mechanism of injury was a fall with the most frequent fracture sources being bed/bunk beds (16.1%), floor (slips/falls, 9.7%) and trampolines (9.7%). Most fractures occurred at the patient's home (58.4%). The incidence of injury outside of the home and frequency of fractures involving play structures/trampolines increased with age. The incidence and demographic characteristics of paediatric femur fractures associated with consumer products have remained consistent over the past 10 years. As home was the most common location of fracture, prevention of femur fractures should focus on caregiver education around high-risk sources of fracture (bed, stairs and trampolines) and manufacturers should consider design alternatives that discourage potential misuse.

Trends in Upper Extremity Saw Injuries From 2003 to 2022.

Saws are a common source of upper extremity injury. There have been several commercial and government-mandated safety mechanisms designed to reduce the number of saw injuries. We aim to assess the trends in the incidence and impact of saw-related upper extremity injuries over the last 2 decades. The National Electronic Injury Surveillance System database was queried from January 2003 to December 2022 for upper extremity injuries caused by saws. Summary statistics for primary body part injured and diagnosis were calculated. Linear regression was performed to evaluate trends in the number of injuries over time. An estimated 1.38 million injuries (weighted) presenting to emergency departments were reported from January 2003 to December 2022. Patients had a mean age of 50.5 ± 18.1. Digits (82.2%) accounted for most injuries, followed by hands (11.9%). The lower arm (3.4%), wrist (1.66%), shoulder (0.3%), elbow (0.2%), and upper arm (0.2%) accounted for fewer injuries. There was a downtrend in number of saw injuries over the study period (R = 0.83, R2 = 0.69, p < .001). Subgroup analysis showed decreases in number of injuries to fingers (R = -0.82, R2 = 0.67, p < .001) and wrists (R = -0.61, R2 = 0.37, p = .004). The most common diagnoses were lacerations (69.7%), fractures (12.6%), and amputations (9.9%). Upper extremity saw injuries have significantly decreased over the last 20 years. The fingers and hands account for the vast majority of saw injuries, resulting most commonly in lacerations, fractures, and amputations. IV.

Accounts of Spine and Paraspinal Disease while Playing Golf

The twisting motion associated with the golf swing puts the intervertebral discs and the paraspinal musculature under stress. The objective of this study was to characterize the spinal and paraspinal pathologies associated with golf and their outcomes. The National Electronic Injury Surveillance System (NEISS) was queried for emergency department visits between 2003-2023 for golf-related injuries with body part codes "neck", "upper trunk", and "lower trunk", which includes the cervical, thoracic, and lumbar spine, respectively. Narratives were screened for relevance and reports related to spinal and paraspinal injuries were included. Weighted survey analysis was utilized to construct national estimates. Injury and diagnosis trends were analyzed using binomial logistic regression, and time trends were analyzed with a linear model. P-value of < 0.05 was considered significant. A total of 1441 relevant samples led to a national estimate of 69,153 emergency department visits for golf-related spinal-/paraspinal injuries between 2003-2023. The weighted mean age of those injured was 52.8 years, and the majority were male (85%, 95% CI 83-87). Strain was the most diagnosed injury (57.5%, 95% CI 54-61). Those aged > 55 years constituted more injuries than any other age group (50.1%, 95% CI 47-53). Injuries in the lumbar region accounted for most cases (76.9%, 95% CI 74-80). Injury frequency did not change over the years (p= 0.54), although the age of injury did increase over time (p < 0.001). Golf-associated paraspinal injuries are more common than neurological injuries, necessitating study into their mechanisms and onset.

Emergency Department Visits After Body Piercings.

There is a paucity of data describing the frequency and complications of body piercing injuries (BPI) in the United States. We conducted a cross-sectional study using the National Electronic Injury Surveillance System (NEISS) to identify emergency department (ED) visits for BPI from 2011-2020 and to estimate prevalence among US individuals ≤24 years of age. Additionally, estimates for infections, requirements for hospitalization/transfer, and exploring significant associations were investigated. A total of 10,912 ED visits extrapolates to a national estimate of 338,972 BPIs in the United States. A majority of BPI involved females (85%), adolescents or young adults (55%), and ears (71%). Foreign bodies comprised 72.6% of BPI. Thirteen percent of ED piercing visits were associated with infection. Of these ED visits for BPI-associated infection, 3% required hospitalization/transfer. In the context of all piercing-associated injuries, injuries to the pubic region were 16.8 times more likely to require hospitalization compared to body piercing injuries of the ear. In the context of all piercing-associated infections, navel (lower trunk), nipple (upper trunk), and oral (mouth) locations were associated with increased odds of infection when compared to BPI infections of the ear. BPI is a common problem in children, adolescents, and youth. Age and body piercing location significantly impact rates of BPI, infection, and hospitalization/transfer. Further study should identify the total number of annual body piercings in the United States. This could generate targeted counseling and risk reduction interventions aimed at specific groups, especially older children who appear to be at increased risk.

Mechanisms and Trends in Women's Lacrosse Head and Musculoskeletal Injuries: A 15-Year Review of National Injury Data.

Head injury rates in lacrosse may be higher among women compared with men. Understanding these trends can guide appropriate injury prevention for female athletes. Injuries most commonly involve the head, with no significant decline over the study period; contact with other players would be the most common injury mechanism. Descriptive epidemiological. Level 3. The National Electronic Injury Surveillance System (NEISS) was queried (January 1, 2008 to December 31, 2022) for women's lacrosse injuries presenting to United States (US) emergency departments (EDs). Patient demographics, injury diagnosis, body part injured, disposition, and clinical narrative were extracted. The provided narrative identified the mechanism of injury. Linear regression analysis assessed trends over time. An estimated 57,635 women's lacrosse injuries occurred during the study period extrapolated from 1899 evaluated NEISS cases. The mean age was 15.81 ± 5.35 years, with 68.3% of injuries sustained by high school (14- to 18-year-old) players. Over one-third of all injuries were to the head (national estimate [NE], 19,358; 33.6%), followed by the ankle (NE, 10,475; 18.2%), then the knee (NE, 6969; 12.1%). Strain/sprains were most common (NE, 19,402; 33.7%) followed by closed head injury (CHI)/sports-related concussion (SRC) (NE, 11,794; 20.5%) and contusion/abrasion (NE, 10,605; 18.4%). ED presentations of CHIs/SRCs and fractures remained elevated with no significant decline over the study period (P > 0.05), despite a significant decrease in strains/sprains and contusions/abrasions (P < 0.01 and P = 0.01, respectively). The most common injury mechanism was collision/contact with another player (NE, 10,664; 18.5%). An estimated one-third of women's lacrosse players in the study sample had a head injury. CHIs and SRCs accounted for 20.5% of all injuries. Given the high proportion of contact-related head injuries, headgear mandates and improved player safety protocols may be warranted.

Epidemiology of Sports-Related Tendon Ruptures Presenting to Emergency Departments in the United States

Background: Participation in recreational and competitive sports can predispose people to musculoskeletal injuries. Chronic overuse with insufficient recovery, overloading, and direct contact can result in acute primary tendon ruptures. There is scarce literature regarding the epidemiology of sports-related acute primary tendon ruptures in the United States (US). Purpose: To identify the incidence rate (IR) of sports-related acute primary tendon ruptures presenting to US emergency departments using the National Electronic Injury Surveillance System (NEISS) database and describe the trends in the IR from 2001 to 2020. Study Design: Descriptive epidemiology study. Methods: The NEISS database was queried using injury case narratives; cases with a clear diagnosis of an acute primary tendon rupture were included in the final analysis. National estimates, estimated IRs (reported as per 1,000,000 person-years at risk), and temporal trends in the annual IR (reported as average annual percent change) of acute primary tendon ruptures were calculated using NEISS sample estimates and US Census Bureau population estimates. Results: An estimated total of 141,382 patients (95% confidence interval [CI], 107,478-175,286) presented to US emergency departments with a sports-related tendon rupture over the study period (IR, 22.9 person-years at risk [95% CI, 17.4-28.3]). The mean age was 37.7 years (95% CI, 37.0-38.5). Of all cases of a tendon rupture identified from 2001 to 2020, 60.1% were secondary to exercise/sports-related injury mechanisms. An Achilles tendon rupture was the most common injury, representing 55.9% of cases. Basketball was the most common sports-related injury mechanism, accounting for 36.6% of cases. The overall injury rate in male patients was 7.7 times that of female patients (IR ratio, 7.7 [95% CI, 4.4-13.5]; P < .05). The annual incidence of all sports-related tendon ruptures in the US increased significantly from 2001 to 2020 (average annual percent change, 1.9 [95% CI, 1.0-2.8]; P < .01). Conclusion: Recreational/competitive sports participation accounted for a large proportion of acute primary tendon ruptures in the US during the study period.

Pacifiers and Teething Devices: A Risk for Craniofacial Injury in Children Under 2 Years Old.

Pacifiers and teething devices are commonly introduced during infancy to soothe and comfort. This study aimed to investigate the incidence of emergency room visits for pediatric craniofacial injuries associated with pacifiers and teething devices. All craniofacial injuries due to "Pacifiers or Teething Rings" in children less than 2 years old were retrieved from the National Electronic Injury Surveillance System (NEISS). Age, sex, race, context of injury, cause of injury, and patient disposition were collected. Query revealed an estimated nationwide incidence of 5424 injuries from the years 2012 to 2021, with a mean age of 12.1 months at the time of injury. Most injuries occurred at home (70.2%), often resulting from falls while using the pacifier/teething device (71.0%). An estimated 97.6% of patients were released after emergency room treatment. Education regarding abstaining from pacifier and teething device use during activity may reduce the incidence of these injuries.

Track and field-related lower-extremity musculoskeletal injuries: A retrospective study discussing injury analysis, stressors, and comprehensive management

Objective This study aims to provide beneficial information, from a clinical perspective, on how healthcare providers and sports educators can navigate treatment and safety for TAF athletes. This was done by identifying trends seen in lower-extremity TAF injuries and providing potential treatments to counter specific injuries, closing gaps in current literature. Methods The National Electronic Injury Surveillance System (NEISS) database was queried during a ten-year time span (2014-2023) to analyze lower-extremity track and field-related musculoskeletal injuries. Results There were 128,761 cases reported in the Emergency Department from 2014-2023. Fifty eight percent occurred in females compared to only 42% in males, making females 1.4 times more likely to experience injury. Most injuries took place in 2017. Most cases in adolescents were aged 15 and 14 years old. The 10-19 age group had disproportionately more cases. 1,067 reported cases of strain/sprains were associated with female patients with 733 cases present in males. Strain/sprains ranked the highest, followed by fractures, excluding other/not stated cases. The ankle was the body part with the most cases, followed by injury to the knee. Conclusions As a widely popular sport, future studies should look at providing a more comprehensive characterization into how a patient’s specific demographics may play into injury detection and prevention.

Upper extremity orthopedic softball injuries presenting to the emergency department: epidemiology across the lifespan

ABSTRACT Background Softball is a popular lifetime sport due to its inclusion of both fastpitch and slowpitch varieties, although associated injuries are common. Objective To compare softball injury rates across patient sex, age, race, injury location, mechanism, and activity. Methods The National Electronic Injury Surveillance System (NEISS) was queried for all upper extremity softball injuries in patients 10–85+ years old presenting to United States emergency departments between 2012 and 2021. Results Significantly more of the 178,303 total weighted upper extremity injuries occurred in female (68.1%) than male (31.9%) athletes (p < .001). Male patients (mean 34.9 ± 13.6 years) were older than female patients (17.4 ± 8.4; p = .019). The average incidence rate of UE injuries from 2012–2021 was 187.9 per 100,000 persons, with a significant decrease in injury incidence across the timespan (p < .001). The lowest annual injury incidence (74.7 per 100,000 persons) occurred in 2020. In patients 10–18 years old, female patients accounted for 95.1% of all injuries, whereas male patients accounted for 72.1% of all injuries in patients aged ≥23. Compared to male patients, females more frequently experienced hand (p < .001), lower arm (p = .007), shoulder (p < .001), and wrist (p < .001) injuries in patients 10–18 years old, finger (p < .001), upper arm (p = .016), and wrist (p < .001) injuries in patients 19–22, and finger injuries (p < .001) in patients aged 23 +. Across all ages, the greatest proportion of injuries were treated and released (p < .001). Most injuries occurred while fielding (41.8%) and due to player-ball contact (36.8%). Conclusion Softball injury ED presentations declined across a decade, including a precipitous drop and rebound effect due to the COVID-19 pandemic. Across the lifespan, upper extremity injuries progressively shifted from female-predominant in younger athletes to male-predominant in adults.

Rising rates of traumatic fractures among mountain bikers: A national review of emergency department visits

Hypothesis/PurposeMountain biking (MTB) is a quickly growing sport, with fractures being the most common injury among MTB athletes. Currently, there is a lack of analysis of MTB fractures based on emergency department (ED) data obtained on a national scale. It was hypothesized that the total number of fractures presenting to United States (US) EDs increased significantly over the last decade, and adult male riders experienced higher rates of fracture and fracture-related hospitalization than other demographics. MethodsAll data was extracted from the National Electronic Injury Surveillance System (NEISS), a public database representing approximately 100 US EDs. NEISS was queried for all MTB-related fractures from January 1st, 2013-December 31, 2022. ResultsNEISS returned a national estimate (NE) of 35,260 MTB fractures visiting EDs between 2013 and 2022. Fracture injuries increased significantly over the study period, including a 247 % increase from 2019 to 2020. The mechanism of injury most likely resulting in fracture was being thrown from the bike (39.6 %, NE:5,436). The upper extremity was the most commonly fractured body region (32.8 %, NE:11,574), and trunk fractures had the highest rate of hospitalization (44.2 %, NE:3705). Males accounted for the majority of fractures (87.9 %, NE:30,996), and were more likely to be hospitalized than females (22.2 %>17.4 %). Adults (age≥40) were more likely to sustain a fracture (48.8 %) and be hospitalized because of it (25.8 %) than other age groups. Adults were also most likely to fracture their trunk (33.9 %). ConclusionMTB fractures increased significantly from 2013 to 2022, possibly due to the gaining popularity of MTB since COVID-19. The upper extremity was the most frequently fractured body region, and being thrown from the bike was the mechanism most likely to result in a fracture. Adult male riders are at a high risk for trunk fractures, demonstrating the importance of protective equipment such as chest and torso protectors for these athletes. Level of EvidenceIII

Consumer product-related female genital injuries in the USA from 2013 to 2022

BackgroundConsumer product-related genital injuries in females across all age groups are understudied. Existing research focuses primarily on paediatric populations. We aimed to determine characteristics, trends and predictors of hospitalisation.MethodsThe National...

Controlled Substance Use in Plastic Surgery Related Emergency Department Visits: An NEISS Study of Burn, Hand, and Face Injuries.

Purpose: Psychoactive substance use is often a complicating factor in injury that requires an emergency room visit. The present study examined data recorded in the National Electronic Injury Surveillance System (NEISS) database for patients who presented to an Emergency Department (ED) and had psychoactive substance involvement, requiring management by plastic surgery. Methods: A retrospective cohort study was performed using the NEISS database, from 2019 to 2021. Data from patients aged 0 to 102 who suffered burns (46, 47, 48, 49, 51, and 73), face injuries (76), hand injuries (34, 82, and 92), and had psychoactive substance use were queried. Data regarding the specific substances involved were collected. Analysis was performed using SAS to compare the incidence of various substances and the differences in admission status with psychoactive substance use. Results: According to the NEISS estimates, in the United States, 597,916 patients visited the ED for burns, 3,671,677 for facial injuries, and 6,230,087 for hand injuries from January 2019 to December 2021. Across this population, psychoactive substance use was noted in 5605 patients with burn (0.9%), 31,198 with facial (0.8%), and 26,174 with hand (0.4%) injuries. Across all 3 injury types, the total rate of admission was 20% in the substance-use population, and 5% in the nonsubstance-use population. Conclusions: For injuries presenting to the ED that require plastic surgery management, patients with documented psychoactive substance use have higher rates of admission. Given these higher rates of admission, it is important for providers to be aware of differences in the incidences of various substances and the potential for withdrawal.

Upper Extremity Injuries in Swimming

Given the rise of swimming as a casual, competitive, artistic, and health-related activity in the past few years, it has become increasingly important to look at injuries that can be caused by swimming. Through studying swimming-related injuries to the upper extremities, swimmers can understand how to prevent major, long-lasting injuries and how to treat these injuries if they occur. The National Electronic Injury Surveillance System (NEISS) Database was used to analyze data on swimming-related injuries to the upper extremities in the last five years. In these past five years, 82,834 injuries to the upper extremities of swimmers have been reported to the Emergency Department (ED). The study highlights the most common upper-extremity-related injury in swimming and how to prevent it, as well as how to treat it. In addition, it is vital to note that future research could delve into possible equipment that would help prevent the injury altogether.

Who breaks their hip? A decade of traumatic hip fracture data

Aims & objectivesHip fractures lead to significant morbidity, mortality, and healthcare costs, particularly in elderly populations. Understanding the mechanisms underlying these fractures is crucial for developing targeted prevention strategies and counseling patients. MethodsThe National Electronic Injury Surveillance System (NEISS) was utilized to identify a cohort of 25,068 hip fractures from 2013 to 2022. The inclusion criteria mandated classification as a lower trunk fracture and explicit mention of hip fracture in the narrative. Patient age, race, sex, incident location, the time of year, and associated consumer products were compared using 95% confidence intervals and Chi-Squared tests of independence. ResultsA total of 25,068 hip fracture patients were included in this study. Females were more likely to fracture their hip (P < .001) representing 68.4% (95% CI 67.8%–69.0%) of all fractures. Patients were most likely to injure themselves at home (P < .001), accounting for 62.0 % (95% CI 61.4%–62.6%) of fractures. Falls to the floor represented 36.0 % (95% CI 35.4%–36.6%) of fractures, while fractures related to beds, stairs, and chairs emerged as other prevalent mechanisms at 11.2% (95% CI 10.8%–11.6%), 7.9% (95% CI 7.5%–8.2%), and 5.4% (95% CI 5.1%–5.7%), respectively. In the 50–60 age group, stairs present a prominent risk, representing 12.4% (95% CI 10.6%–14.5%) of fractures. Younger individuals suffered fractures most commonly due to high energy activities, such as falls from ladders, bicycles, and stairs (P < .001). ConclusionWhile falls remain the chief cause of hip fractures, many of these injuries stem from overlooked mechanisms. The heightened risk associated with falls from beds and chairs in the elderly, stair-related injuries in middle-aged individuals, and high-force modalities in younger people, highlights the necessity for tailored preventive measures. Providers should counsel their patients on risk reduction measures within the home, while Medicare and other insurers must work to expand coverage for these same measures.

The Last Straw: Trends in Straw-Related Emergency Department Visits.

With the recent societal push for eco-sustainability, there has been an increase in the prevalence of reusable utensils, particularly multiuse straws. This study is the first to investigate the epidemiology of plastic, glass, and metal straw-related injuries (SRIs) presenting to the emergency department (ED). The National Electronic Injury Surveillance System database was examined for SRIs from January 2012 through December 2021. Cases were stratified by sex, age, diagnosis, mechanism of injury, and straw material to monitor epidemiological patterns. A total of 1,174 SRIs presented to the National Electronic Injury Surveillance System EDs from January 1, 2012 to December 31, 2021. The majority of injuries occurred among males (55.9%) aged 0-3 years old (43.8%). Injuries caused by reusable straws were significantly more common in patients 3 years old or younger (P < 0.001). Injuries most commonly affect the mouth (45.4%), eyes (22%), and internal structures (13.6%). Lacerations and oral injuries were significantly more common among reusable straw materials (P < 0.001). A 46.5% increase in injuries was noted from 2012 to 2021. The most common mechanism of injury was poking injury (53.5%), followed by stationary falls (19.4%), foreign body (18.7%), running and falling (5.9%), and other (2.4%). Of these cases, 46.3% of injuries were due to the improper use of straws. Metal straw injuries increased 12.8% over the study period. Although most injuries occurred as accidental poking while drinking, nearly half of all injuries were sustained while using straws in an off-label manner. Ensuring the proper use of straws and monitoring children when using a straw may help to decrease the incidence of SRI. Among the options for environmentally friendly straw materials, metal straws pose the greatest risk for injuries requiring ED presentation. Thus, their use should be avoided in the pediatric population.

The Burden of Injuries Associated With E-Bikes, Powered Scooters, Hoverboards, and Bicycles in the United States: 2019‒2022.

Objectives. To describe the national burden of injuries associated with e-bikes, bicycles, hoverboards, and powered scooters (micromobility devices) in the United States. Methods. We compared patterns and trends for 1 933 296 estimated injuries associated with micromobility devices from 2019 to 2022 using National Electronic Injury Surveillance System data. Results. The population-based rates of e-bike and powered scooter injuries increased by 293.0% and 88.0%, respectively. When reported, powered scooter injuries had the highest proportion for alcohol use (9.0%) compared with other modes, whereas e-bike injuries had the highest proportion for motor vehicle involvement (35.4%). Internal injuries were more likely among e-bike diagnoses than hoverboard and bicycle (P < .05), but fractures and concussions were more likely among hoverboard diagnoses compared with all other devices (P < .05). When helmet use was identified in clinical notes (20.3%), helmet usage was higher among e-bike injuries (43.8%) compared with powered scooter (34.8%) and hoverboard (30.3%) injuries but lower compared with bicycle injuries (48.7%). Conclusions. The incidence of severe e-bike and powered scooter injuries increased over the 4-year period. Public health stakeholders should focus on improved surveillance and prevention of injuries associated with electric micromobility devices. (Am J Public Health. Published online ahead of print September 12, 2024:e1-e10. https://doi.org/10.2105/AJPH.2024.307820).

Shifting Trends in the Epidemiology of Cervical Spine Injuries: An Analysis of 11,822 Patients from the National Electronic Injury Surveillance System over Two Decades.

Cervical spine injuries (CSIs) are heterogeneous in nature and often lead to long-term disability and morbidity. However, there are few recent and comprehensive epidemiological studies on CSI. The objective of this study was to characterize recent trends in CSI patient demographics, incidence, etiology, and injury level. The National Electronic Injury Surveillance System was used to extract data on CSIs from 2002 to 2022. Weighted national estimates of CSI incidence were computed using yearly population estimates interpolated from U.S. census data. Data analysis involved extracting additional information from patient narratives to categorize injury etiology (i.e., fall) and identify CSI level. K-means clustering was performed on cervical levels to define upper versus lower cervical injuries. Appropriate summary statistics including mean with 95% confidence intervals and frequency were reported for age, sex, race, ethnicity, etiology, and disposition. Age between groups was compared using an independent weighted Z-test. All categorical variables were compared using Pearson chi-squared tests with Bonferroni correction for multiple comparisons. Ordinary least squares linear regression was used to quantify the rate of change of various metrics with time. A total of 11,822 patient records met the study criteria. The mean age of patients was 62.4 ± 22.7 years, 52.4% of whom were male and 61.4% of whom were White, 7.4% were Black, 27.8% were not specified, and the remaining comprised a variety of ethnicities. The most common mechanism of CSI was a fall (67.3%). There was a significant increase in the incidence of cervical injuries between 2003 and 2022 (p < 0.001). Unbiased K-means clustering defined upper cervical injuries as C1-C3 and lower cervical injuries as C4-C7. The mean age of patients with upper CSIs was 72.3 ± 19.6, significantly greater than the age of those with lower CSIs (57.1 ± 23.1, p < 0.001). Compared with lower CSI, White patients were more likely to have an upper CSI (67.4% vs. 73.7%; p < 0.001). While Black/African American (7.5% vs. 3.8%) and Hispanic (2.5% vs. 1.0%) patients were more likely to have a lower CSI (p < 0.001). Our study identified a significant increase in the incidence of CSIs over time, which was associated with increasing patient age. Our study detected a pragmatic demarcation of classifying upper injuries as C1-C3 and lower cervical injuries as C4-C7. Upper injuries were seen more often in older, White females who were treated and admitted, and lower injuries were seen more often in young, Black male patients who were released without admission.