National Electronic Injury Surveillance System Research Articles

The epidemiology of recreation-related cervical and thoracic fractures

CONTEXTRecreational activities are frequently associated with spinal fracture, yet contemporary characterization of sports-related cervical and thoracic fracture is lacking. PURPOSETo characterize cervical and thoracic fractures associated with recreational activities. STUDY DESIGN/SETTINGRetrospective cohort study. PATIENT SAMPLEThe National Electronic Injury Surveillance System (NEISS) database OUTCOME MEASURE AND COMPARISONSRecreation-related cervical and thoracic fracture incidence rates per year, stratified by age and sex. Common causative activities were established by demographics. METHODSThe NEISS database was queried to identify patients with recreation-related cervical fractures between 2003 and 2022 and recreation-related thoracic fractures between 2003 and 2022 in patients aged >2 years-old. United States Census data was utilized to generate incidence rates per year. Data was stratified by demographic variables to assess the impact of age and sex on incidence and causative activity. RESULTSBetween 2003 and 2022, an estimated 13,823 recreation-related cervical fractures occurred with an average annual incidence of 2.20±0.35 per 1 million person-years, while 24,236 estimated recreation-related thoracic fractures occurred from 2003 to 2022 with an average incidence of 3.85±1.26. Males experienced a 3.51 times higher (95% CI 3.38–3.66) rate of cervical fracture, but thoracic fracture rates were similar between sexes. Individuals under 18 experienced a 2.15 times higher rate of thoracic fractures than those aged 18–64 (95% CI 1.85–2.50) and 1.93 times higher rate than those over 65 (95% CI 1.68–2.22). Recreation-related cervical fracture rates in individuals 18–64 was 1.186 (95% CI 1.14–1.23) times higher than those under 18 and rates in those under 18 were 1.15 (95% CI 1.09–1.22) times higher than those over 65. Football (26.6%), horseback riding (19.7%), and skiing (8.35%) were the primary causes of cervical fractures, and horseback riding (46.8%), football (11.2%), and skiing (10.3%) primarily caused thoracic fractures. Cervical fractures resulted primarily from football in males (24.7%) and horseback riding in females (44.0%). Horseback riding primarily caused thoracic fractures in both sexes (males=21.5%, females=74.7%). Football led causative activities for individuals under 18 (Cervical=42.4%, Thoracic=40.7%), while horseback riding dominated among those aged 18–64 (26.7%, 56.7%) and over 65 (52.8%, 67.9%). CONCLUSIONSThis investigation revealed epidemiological trends in cervical and thoracic spinal fractures and underscore the need for targeted preventive measures and safety interventions to mitigate the burden of these fractures particularly in horseback riding and American football. LEVEL OF EVIDENCELevel III.

Epidemiology of American Football-Related Fractures in the United States 2002-2021.

American football is the most popular sport in the United States, with over 5.6 million people >6 years old playing the sport. Fractures in American football athletes are significant, as they compromise an athlete's performance and can also lead to prolonged recovery periods, affecting team dynamics and player careers. Analyzing these injuries is critical to evaluate preventive measures and tailor rehabilitation strategies to ensure the well-being and sustained peak performance of football athletes on and off the field. To analyze the trend of American football fractures by body site, sex, and age in amateur athletes over a 20-year period between 2002 and 2021. Descriptive epidemiology study. The National Electronic Injury Surveillance System (NEISS) database was queried to characterize football-related fractures and injuries from 2002 to 2021 in patients aged 0-99 years old. National injury estimates were calculated using sample weights. Chi-square analysis and one-way ANOVA were performed to compare categorical variables. Of 56,809 cases of American football-related fractures over 20 years, patients aged 10 to 14 years had the highest incidence of fractures, composing 41.2% of all fractures (n = 23,389), and patients aged <18 years represented 88.8% of all fractures (n = 50,457). The median age of players when fractures occurred was 13 years. Upper extremity fractures (n = 41,863 [73.7%]) were the most common fracture reported compared with lower extremity and head, neck, and trunk fractures. Among upper extremity fractures, finger fractures had the highest prevalence (35.6%), followed by lower arm fractures (19.9%) and wrist fractures (13%). While most cases resulted in release after treatment (93.1%), 5.9% resulted in treatment and hospitalization. When analyzing trends in American football-related fractures over time, we observed the largest number of fractures in 2006 (n = 3664), while the smallest number of fractures occurred in 2020 (n = 1313). Also, a downward trend was found in American football-related fractures since 2006, with a mean of 101 fewer fractures each year. Our analysis showed that American football-related fractures diagnosed in the emergency department in the United States were most likely to occur in pediatric patients (10-18 years old). In addition, patients experiencing American football-related fractures were most likely to have an upper extremity fracture and not require hospitalization. The trend in American football-related fractures has been decreasing since 2006.

Consumer Trends Reflected in the Contents of the Pediatric Esophagus: A 20-Year Review.

To evaluate epidemiological trends of pediatric esophageal foreign body (EFB) ingestion over two decades. A retrospective analysis was performed using data from the National Electronic Injury Surveillance System (NEISS) database for children <18 years who presented to a United States Emergency Department (ED) with EFB between 2003 and 2022. Number of cases and type of EFB were recorded. Rates of EFBs over time were analyzed via linear regression. A total of 52,315 EFB cases were identified over the 20-year period, with a national estimate of 1,589,325 cases. The most frequently ingested objects were coins (37.6%), toys (13.5%), and batteries (6.8%). Overall incidence of EFB ingestion increased from 7.3 to 14.2/10,000 children from 2003 to 2022 (R2 = 0.8, p < 0.0001). Incidence of coin ingestion increased from 3 to 4.5/10,000 children (R2 = 0.06, p = 0.335) but represented a smaller proportion of all EFB over time (66% in 2003 versus 43% in 2022). Incidence of magnet, battery, and toy ingestion have increased from 0.3 to 1.0/10,000 (R2 = 0.9, p < 0.0001), 0.3 to 1/10,000 (R2 = 0.7, p < 0.0001), and 0.6 to 2.3/10,000 (R2 = 0.8, p < 0.0001) children, respectively, between 2003 and 2022. The proportion of magnet, battery, and toy ingestion have increased over time (3.2%, 6.5%, and 11.8%, respectively, in 2003 to 11.4%, 11.7%, and 22.2%, respectively, in 2022). Magnet, battery, and toy ingestion have increased significantly in the past two decades, while the proportion of coin ingestion has decreased. This trend may reflect shifts within the consumer market and increased availability of electronics concurrent with the adoption of digital currency. 4 Laryngoscope, 2024.

Trends and epidemiology of lower trunk fractures in the super elderly population in the United States from 2011 to 2020

IntroductionFractures of the lower trunk are among the most common fractures occurring in the elderly. Super elderly individuals (i.e., those 80 years of age and older) represent a growing segment of the population and are especially prone to these fractures. The contemporary epidemiology of lower trunk fractures in the super elderly population is incompletely described in the literature. Materials and MethodsThis descriptive epidemiology study used the National Electronic Injury Surveillance System (NEISS) to examine the incidence and recent trends of lower trunk fractures (i.e., fractures of the hip, pelvis, and lumbar spine) occurring among super elderly individuals in the United States (US) from 2011 to 2020. Annual, overall, and age-/sex-specific incidence rates (IRs) were analyzed. Average annual percent change (AAPC) estimates were calculated to indicate the magnitude/direction of trends in annual injury rates. ResultsAn estimated N=1,226,160 super elderly patients sustained lower trunk fractures over the 10-year study period for an overall IR of 100.2 per 10,000 person-years at-risk (PYR). Hip fractures accounted for the largest percentage of cases (IR=71.7 PYR), followed by lumbar spine fractures (IR=14.7), and pelvic fractures (IR=14.3). The incidence of lower trunk fractures among super elderly females (IR=121.5 PYR) was significantly greater than that of males (IR=65.7 PYR). The incidence of lower trunk fractures among nonagenarians and centenarians was significantly higher than that of octogenarians. Accounting for population growth yielded a significantly increasing annual incidence of lower trunk fractures in super elderly patients over the study period from 86.7 PYR in 2011 to 107.2 PYR in 2020 (AAPC=2.7, p<0.001). The annual incidence of both pelvic (AAPC=5.8) and lumbar spine (AAPC=6.9) fractures increased at a significantly higher rate than that of hip fractures (AAPC=1.4). ConclusionsThis study suggests that the annual incidence of lower trunk fractures in the oldest cohort of patients in the US (80+ years of age) increased significantly during the recent decade from 2011 to 2020, with pelvic and lumbar fractures in particular becoming increasingly common. Increased incidence rates highlight the need for future research aimed at optimizing outcomes and quality of life in this frail and ever-growing segment of the population.

Mitigating the Risks of Lower Extremity Injuries in Soccer: A Comprehensive Analysis of Lower Extremity Injury Rates in Soccer Between 2014 and 2023.

With events such as the Copa America 2024, the 2026 World Cup, and the arrival of European stars in Major League Soccer (MLS), the already observed and forecasted rise of soccer in the United States (US) seems to be an inevitable outcome. Although regular participation in soccer features several benefits, including increasing cardiovascular health, decreasing stress, and promoting interpersonal relationships, the risk of injury, as is the case in any sport, is ever present. Although many sports that are popular in America feature high rates of concussion, rotator cuff injuries, and general upper extremity injuries, soccer, being more strenuous on the lower-half of the body, features a disproportionate rate of lower extremity injuries. An analysis of the frequencies of these injuries, relative to factors such as year of injury, age, gender, location of injury, and diagnosis of injury, may help organizational bodies and soccer leagues implement new regulations regarding the usage of protective equipment and rules regarding gameplay. This study aims to illuminate these takeaways in an effort to better patient care outcomes in soccer-related injuries. This paper utilized the National Electronic Injury Surveillance System Database (NEISS) to compile data on lower extremity soccer-related injuries within the defined study period, 2014-2023. Inclusion criteria for the study involved all patients presenting to the emergency department (ED) within the study period and within the defined age range of 0 to 69 years old, with injuries sustained from or related to soccer. Using NEISS, trends were elucidated discriminating based on year of injury, sex, age group, location of injury, and diagnosis group of injury. Within the defined study period of 10 years, from 2014-2023, there were approximately 843,063 total soccer-related lower extremity injuries which presented to various EDs across the US. Regarding majorities, the most injuries were sustained in 2014 (12.84% of total injuries), most patients sustaining injuries were male (66.6% of all patients), and within the age range of 10-19 years old (63.24% of all patients), with the most instances occurring at age 15. Lower extremity injuries were most reported to be affecting the ankle with 306,797 incidences (36.39% of total injuries seen) and the most frequent diagnosis group was reported to be strains/sprains with 396,420 (47.02% of total injuries seen) total occurrences. This study analyzes the incidents of lower extremity injuries while participating in soccer for the last 10 years, 2014-2023. The study provides new data regarding the frequency of injuries and their relative rate with respect to year of injury, age group, sex, location of injury, and diagnosis. The results of this study show injury majorities and trends which can be used to dictate changes in regulation regarding gameplay and the utilization of protective equipment in order to mitigate injuries related to the lower extremities in soccer.

Pediatric Toy-Related Ocular Injuries in the United States: A National Electronic Injury Surveillance System Study

ABSTRACT Purpose The purpose of this study is to evaluate the epidemiological trends, primary ocular diagnosis, and degree of injury severity in pediatric patients after a toy-related ocular trauma. Methods A cross-sectional analysis was conducted using data from the National Electronic Injury Surveillance System Study (NEISS), encompassing patients who visited emergency departments over a 5-year period from January 1, 2017, to December 31, 2021, with toy-related ocular injuries. Descriptive statistics were employed using Microsoft Excel. Results Among the 1439 toy-related ocular injuries identified, the mean age of injury was 6.67 ± 4.36 years. The highest proportion of injuries occurred in the 2–5 years age group (27.2%). The NEISS database classified the severity of injury – the majority of which were minor anterior segment injuries. Toy guns with projectiles were identified as the most common type of toy associated with ocular eye injury. While most injuries were minor, a small percentage was severe. Conclusion Age-appropriate toy selection and adult supervision during playtime are recommended preventive measures to mitigate the incidence and severity of traumatic eye injuries in children.

Structural housing elements associated with injuries in older adults in the USA

ObjectiveTo quantify the unintentional injuries associated with housing elements among older adults treated in US hospital emergency departments (EDs). To identify modifiable home hazards.MethodsThe National Electronic Injury Surveillance System (NEISS)...

Orthopedic injuries due to hoverboard use, reported in the NEISS database, 2015–2022

IntroductionHoverboards are a popular means of recreation in the United States and are associated with significant injury risk, leading to recent efforts to improve their safety. Prior studies on hoverboard-related injuries were either conducted prior to implementation of safety regulations, consisted of short study intervals, or did not place a focus on injuries as they pertain to the orthopedic specialist. The purpose of this study is to provide an updated assessment of the epidemiology of orthopedic hoverboard-related injuries presenting to US emergency departments. Materials and MethodsA retrospective analysis from 2015 to 2022 of the National Electronic Injury Surveillance System (NEISS) database was conducted, limited to product codes detailing hoverboard-related injuries leading to emergency department visits. Diagnoses of interest included fractures, dislocations, contusions/abrasions, and strains/sprains. Diagnoses were further broken down to analyze anatomic region affected. National estimates (NE) were calculated using survey methods. One-way ANOVA and chi square tests were used to test for changes over time in injuries, age, and gender. Results4,718 total hoverboard-related injuries were captured, with a national estimate of 154,121. The majority of patients were under 18 years old (79.6 %; P < 0.001) and female (52.5 %; P = 0.038). Orthopedic injuries accounted for 68.6 % of the total, with no significant year-by-year change in this proportion (P = 0.069). Fractures were the most common orthopedic injury (64.2 %), followed by contusions/abrasions (20.2 %), strains/sprains (14.6 %), and dislocations (1.0 %). Most fractures affected the forearm (33.8 %) followed by the wrist (29.2 %). Injuries peaked in 2018 (NE = 25,192) and 2020 (NE = 24,958), followed by a decline in incidence more recently. ConclusionHoverboard-related injuries continue to be a common presentation to US emergency departments, though injury rates appear to be decreasing. Orthopedic injuries consistently account for the majority of hoverboard-related injuries reporting to emergency departments, with fractures of the forearm and wrist being most common. Continued efforts toward improving safety measures regarding hoverboard use are warranted.

Pediatric Concussions in Contact Sports: A 10-Year Retrospective Analysis of Mechanisms and Associated Symptoms.

Concussions make up a significant proportion of sports injuries. This study aimed to describe the mechanisms of injury and associated symptoms of pediatric patients diagnosed with concussions (age range, 4-17 years) from contact sports. Mechanisms of injury would differ based on sex and age, with female athletes and younger athletes aged 4 to 11 years sustaining fewer concussions from player-to-player contact. Descriptive epidemiology study. The National Electronic Injury Surveillance System was queried for all contact sport concussions presented to United States emergency departments. The sports analyzed included basketball, football, soccer, hockey, rugby, and lacrosse. Descriptive data, mechanisms of injury, and associated symptoms were analyzed for each sport. Differences in the number of concussions sustained by year and sport, the severity of the injury, and associated symptoms were compared using chi-square test, and differences in proportion were calculated for mechanisms of injury stratified by sex and age. A total of 12,602 youth athletes sustained concussions between 2012 and 2021. Most patients were male (78.5%), with a mean age of 13.48 years. Football concussions were the most common, with 45.32% of the concussions. The mechanism of injury was largely sport-specific, with player-to-player contact the most common overall. Older male athletes were more likely to have concussions from player-to-player contact, whereas younger athletes were more impacted by head-to-ground mechanisms. Symptom presentation was not sport-specific, and headache and dizziness were the most common presentation at 41.2% and 26.2%, respectively. The most important overall mechanism of injury was player-to-player contact, especially in older male youth athletes, whereas younger athletes were more likely to be concussed due to head-to-ground injuries.

Use of Generative AI to Identify Helmet Status Among Patients With Micromobility-Related Injuries From Unstructured Clinical Notes

Large language models (LLMs) have potential to increase the efficiency of information extraction from unstructured clinical notes in electronic medical records. To assess the utility and reliability of an LLM, ChatGPT-4 (OpenAI), to analyze clinical narratives and identify helmet use status of patients injured in micromobility-related accidents. This cross-sectional study used publicly available, deidentified 2019 to 2022 data from the US Consumer Product Safety Commission's National Electronic Injury Surveillance System, a nationally representative stratified probability sample of 96 hospitals in the US. Unweighted estimates of e-bike, bicycle, hoverboard, and powered scooter-related injuries that resulted in an emergency department visit were used. Statistical analysis was performed from November 2023 to April 2024. Patient helmet status (wearing vs not wearing vs unknown) was extracted from clinical narratives using (1) a text string search using researcher-generated text strings and (2) the LLM by prompting the system with low-, intermediate-, and high-detail prompts. The level of agreement between the 2 approaches across all 3 prompts was analyzed using Cohen κ test statistics. Fleiss κ was calculated to measure the test-retest reliability of the high-detail prompt across 5 new chat sessions and days. Performance statistics were calculated by comparing results from the high-detail prompt to classifications of helmet status generated by researchers reading the clinical notes (ie, a criterion standard review). Among 54 569 clinical notes, moderate (Cohen κ = 0.74 [95% CI, 0.73-0.75) and weak (Cohen κ = 0.53 [95% CI, 0.52-0.54]) agreement were found between the text string-search approach and the LLM for the low- and intermediate-detail prompts, respectively. The high-detail prompt had almost perfect agreement (κ = 1.00 [95% CI, 1.00-1.00]) but required the greatest amount of time to complete. The LLM did not perfectly replicate its analyses across new sessions and days (Fleiss κ = 0.91 across 5 trials; P < .001). The LLM often hallucinated and was consistent in replicating its hallucinations. It also showed high validity compared with the criterion standard (n = 400; κ = 0.98 [95% CI, 0.96-1.00]). This study's findings suggest that although there are efficiency gains for using the LLM to extract information from clinical notes, the inadequate reliability compared with a text string-search approach, hallucinations, and inconsistent performance significantly hinder the potential of the currently available LLM.

Seeing through the strikes: a comprehensive study of ocular injuries in martial arts from 2012 to 2021

PurposeOver 6 million people in the United States participate in martial arts, and the focus on striking the face poses a significant risk of injury to the eye. The objective of this study is to characterize the nature and incidence of martial arts-related eye injuries in the United States. MethodsA retrospective analysis of the National Electronic Injury Surveillance System (NEISS) database served as the basis of the study. The NEISS database was queried for eye injuries related to martial arts from 2012 to 2021. The entries that resulted were coded for demographic information, mechanism of injury, martial arts discipline, and diagnosis. Data were analyzed using SPSS version 28 through descriptive and χ2 analyses. ResultsThere were 162 reported cases of martial arts-related eye injuries in 4- to 62-years-old patients with most injuries occurring in males (84%). The most represented martial arts discipline was boxing (30.5%), and the most frequently reported mechanism of injury was punching (30.2%). The most frequently reported diagnosis resulting from eye injury was corneal abrasion (40.5%), while sight-threatening diagnoses were reported, including retinal detachment (n = 4), vitreous hemorrhage (n = 2), and open globe (n = 2). ConclusionsDespite the significant risk of ocular injury from martial arts, corneal abrasion was the most commonly diagnosed with excellent prognosis. Sight-threatening diagnoses were also reported, indicating that martial arts athletes should be educated about the risks of eye injury and the importance of regular eye examination when practicing combat sports.

Pediatric water bead-related visits to United States emergency departments

ObjectiveTo evaluate the characteristics and trends of pediatric water bead-related visits to US emergency departments (EDs) using a large national database. MethodsData from the National Electronic Injury Surveillance System regarding ED visits by individuals <20 years old associated with water beads from January 1, 2007, through December 31, 2022, were retrospectively analyzed. ResultsBased on 307 reported cases, there were an estimated 8159 visits (95% CI: 4447-11,870) to US EDs from 2007 through 2022 involving water beads among <20-year-olds, and more than half (55.0%) of the 307 ED cases involved <5-year-olds. Most cases were treated and released (92.2%), which was consistent across all age groups. The proportion of cases admitted was highest among children <5 years old (10.1%), and this age group accounted for 17 of the 19 admissions (89.5%) in this study. All admissions among children <5 years old involved ingestions. Ingestion was the most common mechanism of injury (45.9%), followed by ear canal insertion (32.6%), nasal insertion (11.7%), and eye injury (8.8%). Although ingestions occurred most frequently among children one (28.4%) and two (23.4%) years of age, children 3 and 4 years old accounted for one-fifth of ingestions. The number of ED cases increased rapidly by 130.9% from 55 cases in 2021 to 127 in 2022. ConclusionsThe number of pediatric water bead-related ED visits is increasing rapidly. Children <5 years old are most commonly involved, usually via water bead ingestion. Increased prevention efforts are needed.

Lower Body Weightlifting Injuries Treated in United States Emergency Departments from 2012-2021.

Weightlifting has become an increasingly popular form of exercise that has been shown to have many health benefits but can be dangerous if performed improperly. The objective of this study was to describe the epidemiology of lower body weightlifting injuries in the United States. The National Electronic Injury Surveillance System database was queried from January 1, 2012, to December 31, 2021, for lower body injuries related to using weightlifting equipment. Demographics, diagnosis, disposition, and mechanism of injury (MOI) were analyzed. There were 7,773 lower extremity weightlifting injuries identified from 2012-2021, giving a national estimate of 311,842 injuries. The most common MOI was dropped weight (n=1785, 22.96%). Deadlifts were the most cited exercise that led to lower extremity injury (n=503, 6.47%). Males were more likely than females to be injured (76% males vs. 24% females; p<0.001), especially by compound movements with free weights including squats (79.63% males vs. 19.96% females, p<0.03) and deadlifts (83.89% males vs. 16.10% females, p<0.001). Nearly all injuries were treated as outpatient but those admitted to the hospital were significantly older than those treated as outpatients (38.0 years vs. 31.2 years, p<0.05). Weightlifting carries a high risk of injury due to the intensity and technique required for the different movements involved.

Water bead injuries by children presenting to emergency departments 2013-2023: An expanding issue.

A 2023 product recall has described the risk for morbidity and mortality for children ingesting water beads. We aimed to describe water bead exposure and management trends in the United States.We used the National Electronic Injury Surveillance System (NEISS) to identify water bead injuries from 2013 to 2023. Inclusion criteria were ages 0-17 years, diagnosis of ingested object/foreign body, and the narrative word(s) suggested water bead(s). NEISS supplied weights and variance variables to generate national estimates. There were 226 water bead injuries (66% ingestion). Children under age 2 years comprised 29% of injuries. Multiple water beads were involved in 56% of cases. There was a significant uptrend in water bead injury frequency after 2020. Sixteen (7%) cases required escalation of care. Water bead injuries are rising and appear to affect children of all ages. Children aged less than 5 years appear most vulnerable.

Injuries With Electric vs Conventional Scooters and Bicycles.

Micromobility, the use of small vehicles (primarily scooters and bicycles), has become a standard transportation method in the US. Despite broad adoption of electric micromobility vehicles, there is a paucity of data regarding the injury profiles of these vehicles, particularly in the US. To characterize micromobility injury trends in the US, identify demographic characteristic differences in users of electric and conventional vehicles, and identify factors associated with hospitalization. This cross-sectional study queried the National Electronic Injury Surveillance System, a comprehensive database that collates injury data associated with consumer products from emergency departments across the US to provide national estimates, from calendar year 2017 to 2022. Data on micromobility vehicle injuries (bicycles, scooters, electric bicycles [e-bicycles], and electric scooters [e-scooters]) were obtained. Trends in injury and hospitalization counts, injury characteristics, and factors associated with hospitalization. From 2017 to 2022, the US recorded 2 499 843 bicycle (95% CI, 1 948 539-3 051 147), 304 783 scooter (95% CI, 232 466-377 099), 45 586 e-bicycle (95% CI, 17 684-73 488), and 189 517 e-scooter (95% CI, 126 101-252 932) injuries. The median age of the riders was 28 (IQR, 12-51) years; 72% were male, 1.5% Asian, 13% Black, 12% Hispanic, and 49% White. Annual e-bicycle and e-scooter injuries increased from 751 (95% CI, 0-1586) to 23 493 (95% CI, 11 043-35 944) and injuries increased from 8566 (95% CI, 5522-11 611) to 56 847 (95% CI, 39 673-74 022). Compared with conventional vehicles, electric vehicle accidents involved older individuals (median age, 31 vs 27 years; P < .001) and a higher proportion of Black riders (25% vs 12%; P < .001). Helmet use was less in electric vehicle incidents compared with conventional vehicles (43% vs 52%; P = .02), and injuries were more common in urban settings (83% vs 71%; P = .008). Age-adjusted odds of hospitalization among all Black individuals compared with White individuals was 0.76 (95% CI, 0.59-0.98; P = .04). In this cross-sectional study of micromobility vehicles, an increased number of injuries and hospitalizations was observed with electric vehicles compared with conventional vehicles from 2017 to 2022. These findings suggest the need for change in educational policies, infrastructure, and law to recenter on safety with the use of micromobility vehicles.

Investigating Thoracic Vertebral Fractures in Residential Environments

IntroductionThoracic vertebral fractures within homes are pivotal public health concerns due to their associated morbidity and significant healthcare expenditures. This study aims to dissect the intricate epidemiology of these injuries, integrating comprehensive risk factors beyond conventional demographics and location analyses. MethodsUtilizing a decade of data (2013-2022) from the National Electronic Injury Surveillance System (NEISS), this study examines thoracic vertebral fractures across age and gender in household settings. Inclusion criteria targeted specific thoracic spine-related terms, analyzing fractures by location (e.g., kitchen, stairs) and associated products. Data processing employed R programming, with statistical analysis focusing on descriptive statistics and multivariate logistic regression to identify fracture patterns and assess gender differences in fracture risks through Adjusted Odds Ratios (AORs). ResultsAnalysis of 46,371 thoracic vertebral fractures identified stairs as the primary site (26.81%), with subsequent frequent locations being bedrooms (18.52%), living rooms (17.88%), and kitchens (16.29%). Gender-specific risk analysis revealed females had a higher likelihood of fractures on stairs (AOR = 1.24, 95% CI: 1.16-1.37, p < .001) and in bedrooms (AOR = 1.13, 95% CI: 1.09-1.54, p < .001). The most affected age group was 51-60, showcasing the multifaceted nature of risk factors beyondmere location. DiscussionThis study transcends prior insights by detailing the influence of various factors, including socioeconomic status and lifestyle, on fracture risk. It emphasizes the complexity of household fractures, highlighting gender and age as pivotal but not exclusive risk determinants. ConclusionBy offering a comprehensive analysis that incorporates a wide array of risk factors, this study advances the understanding of thoracic vertebral fractures in residential environments. It underscores the necessity for targeted preventive measures that are cognizant of the multifactorial nature of these injuries, paving the way for improved safety interventions and public health policies.

Monkey Bar-Associated Pediatric Fractures: A National Epidemiologic Study of Emergency Department Visits.

Emergency department (ED) visits because of pediatric fractures are not only burdensome for patients and their families but also result in an increased healthcare expenditure. Almost half of all children experience at least one fracture by the age of 15. Many fractures occur in playgrounds, with monkey bars and other climbing apparatuses noted as frequent mechanisms of injury. Our purpose was to identify the pattern of injury and the population sustaining monkey bar-associated fractures. We queried the National Electronic Injury Surveillance System database for all monkey bar-associated injuries in patients aged 0 to 18 years from January 1, 2009, to December 31, 2019. We described demographic data, patient disposition from the ED, fracture pattern, and injury setting using unweighted and weighted estimates. Weighted results that more closely reflect national estimates were calculated. During the study period, 30,920 (862,595 weighted) monkey bar-associated injuries presented to EDs; 16,410 (53.1%) (weighted injuries: 408,722 [47.4%]) were fracture injuries. The average age of kids sustaining fractures was 6.5 years, with most injuries (66.4%) occurring in kids between 6 and 12 years. A higher percentage of male patients presented to the ED with fractures compared with female patients (53% versus 47%). Upper extremity fractures were most common, 382,672 (94%) with forearm fractures constituting the majority (156,691 [38%]). Most children were treated and released (354,323 [87%]), with only 35,227 children (9%) being admitted for treatment. Places of recreation/sports were the most common setting of fractures (148,039 [36%]), followed by schools (159,784 [39%]). A notable association was observed between year and ethnicity and between month period and injury setting. Monkey bar-associated injuries are a major cause of upper extremity fractures in children, with most injuries occurring in recreational areas or schools. Young elementary school children are at the highest risk of injury. ED visits because of monkey bar-associated fractures have increased over the study period, and these injuries continue to be a major cause of fractures in children. Additional measures should be installed to decrease these preventable fractures among children, with schools as a potential starting point.

Poster 177: Snowboarding Related Concussions and Musculoskeletal Injuries in the Pediatric Population: An 11-Year Analysis of National Injury Data

Objectives: Snowboarding is a high energy sport associated with traumatic musculoskeletal injury. Although the pediatric population constitutes most snowboarding injuries, no study has investigated this cohort in further detail. The purpose of this study is to analyze underlying etiologies, diagnoses, and injury trends of pediatric snowboarding injuries presenting to United States emergency departments. Methods: Data from the National Electronic Injury Surveillance System (NEISS) were analyzed for pediatric snowboarding injuries (≤18 years old) from January 1, 2012 to December 31, 2022. Data were collected for mechanism of injury, diagnosis, location of injury, and disposition. National estimates (NE) were calculated using the statistical sample weight of the corresponding hospital assigned by the NEISS. Linear regressions were used to analyze injury trends over time. Results: In total, 3,036 (NE=120,140) pediatric snowboarding injuries were included in this study. Average age was 14.0 ± 2.7 years. The most common mechanism of injury was impact with the ground (NE=97,120, 80.8%). The most common diagnoses were fractures (NE=48,886, 40.7%), strains/sprains (NE=22,948, 19.1%), and concussions (NE=12,553, 10.4%). Most common fractures occurred at the wrist (NE=18,122, 37.1%), lower arm (NE=12,348, 25.3%), and shoulder (NE=9,073, 18.6%). Overall, 96.1% injuries were treated without admission. There were decreases of 1,051 injuries (p&lt;0.01), 299 fractures (p=0.04), 298 strains/sprains (p&lt;0.001), and 143 concussions (p&lt;0.01) per year during the study period. Mechanisms of injury demonstrated decreasing annual trends of 784 impact with ground injuries per year (p&lt;0.01), 161 not specified injuries per year (p&lt;0.01), and 42 impact with inanimate object injuries per year (p=0.03). Conclusions: There was a large decline in pediatric snowboarding injuries over the last decade. Given the small proportion requiring hospital admission, the decline may reflect increasing on-site management of less-severe snowboarding injuries. These findings also highlight the importance of protective equipment considering the large proportion of injuries secondary to impact with the ground.

A Five-Year Overview of Bicycle Injuries in the United States Between the Years 2017 and 2021.

Introduction This study investigates the changes in bicycle-related injury rates between 2017 and 2021. We focus specifically onchanges in age demographics, and the most common diagnosesand body parts injured. Methods We queried the National Electronic Injury Surveillance System (NEISS) for injuries associated with bicycles from 2017 to 2021. Chi-square analysis was used to evaluate trends in injuries vs. time for the entire sample, age groups in five-year increments, and the proportion of injury types by diagnosis and body part. Results The highest annual injury rate (12,800 counts) occurred in 2020, coinciding with the COVID-19 safer-at-home order. Pediatric patients continue to make up the majority of injured cyclists (48% of patients are younger than 19 years), but their percentage is decreasing (zero to four years (-13%, p < 0.005), five to nine years (-17%, p < 0.005), 10-14years (-5%, p < 0.005), 20-24years (-16%, p < 0.005), 25-29 years (-2%, p < 0.005), and 50-54 years (-14%, p < 0.005)) and mirrored by an increase in the proportion of older injured cyclists (40-44years (+26%, p < 0.005), 60-64years (+44%, p< 0.005), 65-69years (+69%, p < 0.005), and 70+years (+57%, p < 0.005)). The past five years saw an increase in injuries associated with higher impact forces and the potential for more severe morbidity and mortality, such as internal organ injuries (+13%, p < 0.01). The incidence of concussions, however, has not changed significantly. The extremities are the most commonly injured body parts(upper and lower arm, elbow, wrist, hand, fingers, upper and lower leg, knee, ankle, foot, and toe = 47% total) and continue to increase in frequency (lower arm (+2%, p < 0.005), lower leg (+3%, p < 0.01), upper arm (+18%, p < 0.005), and hand (+11%, p < 0.05)), while facial injuries are becoming less common(-3%, p < 0.05), and head injuries have not experienced a significant change of incidence. Conclusion Although there was an increase in bicycle-related injuries during the COVID-19 safer-at-home order, numbers have since returned to pre-COVID-19 levels. Other changes in bicycle injury demographics and mechanisms, such as a rise in older adult cyclists and high-force mechanism injuries, however, call for a re-evaluation of preventive and treatment priorities.

Injuries Related to Waterskiing Between 2012 and 2022: A National Database Study.

We conducted an epidemiological study by using the National Electronic Injury Surveillance System (NEISS) databaseto assess and quantify waterskiing injuries between 2012 and 2022. A total of 898 injuries were reported, primarily among Caucasian males during competition. Head (177, 20%), face (93, 10%), and knee (70, 8%) were the most prevalent types of injuries.Common physical examination findings included muscle strains, ligament sprains, lacerations, and fractures. Although rare, there were reported cases of dental injury, hemorrhage, crushing, foreign body, and amputation as well. These findings suggest that protective equipment, particularly headgear, is necessary to reduce the incidence of waterskiing injuries.