scholarly journals Playground equipment-related extremity fractures in children presenting to US emergency departments, 2006–2016

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Ashley Blanchard ◽  
Ava Hamilton ◽  
Guohua Li ◽  
Peter S. Dayan
Keyword(s):  
Emergency Departments ◽  
The United States ◽  
Rate Of Change ◽  
Annual Rate ◽  
Common Source ◽  
Survey Analysis ◽  
Injury Surveillance System ◽  
Safety Standards ◽  
Fractures In Children ◽  
Industry Standards

Abstract Background Despite updated playground equipment and improved industry standards, playgrounds remain a common source of childhood injury. Fractures account for 35% of all playground injuries presenting to emergency departments (EDs). We aimed to examine the time trends and epidemiologic patterns of playground equipment-related extremity fractures in children in the United States. Methods We analyzed data from the National Electronic Injury Surveillance System. Children ≤14 years presenting to US emergency departments from 2006 to 2016 with playground equipment-related injuries were included. We used weighted complex survey analysis to describe the epidemiologic patterns and severity of playground equipment-related extremity fractures and Joinpoint linear weighted regression analysis to determine trends in extremity fractures. Results An annual average of 72,889 children were treated in US EDs for playground equipment-related extremity fractures, yielding a national annual incidence rate of 119.2 per 100,000 children. Playground equipment-related extremity fractures accounted for 33.9% of ED presentations and 78.7% of hospitalizations for playground equipment-related injuries. Of patients with playground equipment-related extremity fractures, 11.2% had severe fractures requiring hospitalization. The annual rate of ED visits due to playground equipment-related extremity fractures remained stable (annual rate of change = 0.74, p = 0.14) from 2006 to 2016. Adjusted for age, injuries on monkey bars or climbing gyms were associated with significantly increased odds of extremity fractures in comparison to injuries from other playground equipment (adjusted odds ratio [aOR]: 2.0; 95% CI: 1.9–2.1). Overall, 49.8% of extremity fractures and 54.7% of severe extremity fractures (i.e. those requiring hospitalization) occurred on monkey bars or climbing gyms. Conclusions Despite enhanced playground safety standards, national rates of playground equipment-related extremity fractures have remained stable in the US. Extremity fractures remain the most common type of playground injury presenting to EDs and most commonly occur on monkey bars and climbing gyms.

Pediatric Playground-Related Injuries Treated in Hospital Emergency Departments in the United States

2017 ◽  
Vol 57 (5) ◽  
pp. 584-592 ◽  
Author(s):  
Sarah L. Adelson ◽  
Thitphalak Chounthirath ◽  
Nichole L. Hodges ◽  
Christy L. Collins ◽  
Gary A. Smith
Keyword(s):  
Emergency Departments ◽  
Closed Head Injury ◽  
Injury Rate ◽  
The United States ◽  
Injury Surveillance System ◽  
Safety Standards ◽  
Average Patient ◽  
Impact Attenuation ◽  
Standards And Guidelines ◽  
Hospital Emergency Departments

This study analyzed pediatric playground-related injuries data from the National Electronic Injury Surveillance System. An estimated 5 025 440 children <18 years were treated in US emergency departments for playground-related injuries during 1990-2012, averaging 218 497 children annually. The average patient age was 6.5 years. The overall annual injury rate declined during 1990-2007 ( P < .001) and then increased during 2007-2012 ( P < .001). The climbing equipment–related injury rate remained constant during 1990-2009 and then increased during 2007-2012 ( P = .014). The concussion/closed head injury rate increased during 1990-2008 ( P < .002) with the rate almost doubling from 2008-2012 ( P < .001). Falls accounted for 76.7% of all injuries and 87.7% of injuries to the upper extremities. Injuries resulted in hospitalization for 4.3% of patients. Despite current playground safety standards and guidelines, a large number of playground-related injuries continue to occur. Revised impact attenuation criteria for playground surfacing materials should be implemented and evaluated to more adequately prevent fall-related upper extremity fractures.

Feel the Burn! Fireworks-related Otolaryngologic Trauma

2021 ◽  
pp. 000348942110081
Author(s):  
Alexander J. Straughan ◽  
Luke J. Pasick ◽  
Vrinda Gupta ◽  
Daniel A. Benito ◽  
Joseph F. Goodman ◽  
...  
Keyword(s):  
United States ◽  
Head And Neck ◽  
Emergency Departments ◽  
Closed Head Injury ◽  
Penetrating Trauma ◽  
The United States ◽  
Neck Injuries ◽  
Chi Square ◽  
Injury Surveillance System ◽  
Cross Sectional

Objectives: Fireworks are used commonly for celebrations in the United States, but can lead to severe injury to the head and neck. We aim to assess the incidence, types, and mechanisms of head and neck injuries associated with fireworks use from 2010 to 2019. Methods: A retrospective cross-sectional study, using data from the National Electronic Injury Surveillance System, of individuals presenting to United States Emergency Departments with head and neck injuries caused by fireworks and flares from 2010 to 2019. Incidence, types, and mechanisms of injury related to fireworks use in the US population were assessed. Results: A total of 541 patients (349 [64.5%] male, and 294 [54%] under 18 years of age) presented to emergency departments with fireworks-related head and neck injuries; the estimated national total was 20 584 patients (13 279 male, 9170 white, and 11 186 under 18 years of age). The most common injury diagnoses were burns (44.7% of injuries), laceration/avulsion/penetrating trauma (21.1%), and otologic injury (15.2%), which included hearing loss, otalgia, tinnitus, unspecified acoustic trauma, and tympanic membrane perforation. The remaining 19% of injuries were a mix, including contusion, abrasion, hematoma, fracture, and closed head injury. Associations between fireworks type and injury diagnosis (chi-square P < .001), as well as fireworks type by age group (chi-square P < .001) were found. Similarly, associations were found between age groups and injury diagnoses (chi-square P < .001); these included children 5 years and younger and adults older than 30 years. Conclusions: Fireworks-related head and neck injuries are more likely to occur in young, white, and male individuals. Burns are the most common injury, while otologic injury is a significant contributor. Annual rates of fireworks-related head and neck injuries have not changed or improved significantly in the United States in the past decade, suggesting efforts to identify and prevent these injuries are insufficient.

scholarly journals PEAK LOWER EXTREMITY SOCCER INJURIES OCCUR IMMEDIATELY FOLLOWING GROWTH IN ADOLESCENTS: AN EPIDEMIOLOGIC REVIEW OF EMERGENCY DEPARTMENT VISITS

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0021
Author(s):  
Aidan P. Wright ◽  
Aaron J. Zynda ◽  
Jane S. Chung ◽  
Philip L. Wilson ◽  
Henry B. Ellis ◽  
...  
Keyword(s):  
Emergency Department ◽  
Lower Extremity ◽  
Emergency Departments ◽  
Skeletal Maturity ◽  
Epidemiologic Study ◽  
The United States ◽  
Emergency Department Visits ◽  
Injury Surveillance System ◽  
Lower Extremity Injuries ◽  
Extremity Injuries

BACKGROUND: Soccer has become the most popular youth sport in the world. Within the last decade, there has been limited epidemiologic research on pediatric soccer-related injuries based on sex and age. PURPOSE: To examine trends associated with soccer injuries presenting to emergency departments and to describe differences in injury pattern and location based on sex and age during periods of growth. METHODS: An epidemiologic study was conducted utilizing publicly accessible data from the National Electronic Injury Surveillance System (NEISS). The NEISS compiles Emergency Department (ED) data on all injuries presenting to the approximately 100 participating network hospitals in the United States. Information on all soccer-related injuries occurring in ages 7-19 from January 2009 – December 2018 was extracted and summary statistics were calculated. RESULTS: Approximately 54,287 pediatric soccer-related injuries were identified. The average age for all injuries was 13.3 years, and males (60.50%) presented more often than females (39.50%). Concussions and head injuries (15.57%) were most commonly reported overall, with a greater percentage occurring in females than males (17.44% vs. 14.35%). The ankle (15.3%) was the second most common injury location with females also presenting more commonly than males (18.71% vs. 13.62%). Age and sex-based evaluation noted peaks in lower extremity injuries in females younger than in males. Both ankle (F=13-15 years, M=15-17 years) and knee (F=14 years, M=16 years) injuries peaked at ages coinciding with recognized sex-based lower extremity skeletal maturity (Figure 1). CONCLUSION: Peak pediatric soccer-related ankle and knee injuries presenting to emergency departments occur at different ages in females and males and appear to, on average, coincide with maturation (age 14 in females and 16 in males). Lower extremity injuries significantly increase nearing the completion of lower extremity growth, and may indicate appropriate timing for differential sex-specific injury prevention programs within soccer. [Figure: see text]

Pediatric Cheerleading Injuries Treated in Emergency Departments in the United States

2017 ◽  
Vol 56 (11) ◽  
pp. 985-992 ◽  
Author(s):  
Nada Naiyer ◽  
Thiphalak Chounthirath ◽  
Gary A. Smith
Keyword(s):  
United States ◽  
Emergency Departments ◽  
Closed Head Injury ◽  
Injury Rate ◽  
The United States ◽  
Common Mechanism ◽  
Injury Surveillance System ◽  
Injury Mechanisms ◽  
States Data ◽  
Closed Head

This study investigates the epidemiology of cheerleading injuries to children in the United States. Data were analyzed from the National Electronic Injury Surveillance System for children 5 through 18 years of age treated in US emergency departments for cheerleading injuries from 1990 through 2012. An estimated 497 095 children ages 5 to 18 years were treated in US emergency departments for a cheerleading injury during the 23-year study period, averaging 21 613 injured children per year. From 1990 to 2012, the annual cheerleading injury rate increased significantly by 189.1%; and from 2001 to 2012, the annual rate of cheerleading-related concussion/closed head injury increased significantly by 290.9%. Falls were the most common mechanism of injury (29.4%) and were more likely to lead to hospitalization (relative risk = 2.47; 95% confidence interval = 1.67-3.68) compared with other injury mechanisms. The rising number and rate of pediatric cheerleading injuries underscore the need for increased efforts to prevent these injuries.

scholarly journals Child Development and Pediatric Sport and Recreational Injuries by Age

2014 ◽  
Vol 49 (6) ◽  
pp. 780-785 ◽  
Author(s):  
David C. Schwebel ◽  
Carl M. Brezausek
Keyword(s):  
United States ◽  
Emergency Department ◽  
Emergency Departments ◽  
Injury Risk ◽  
The United States ◽  
Emergency Department Visits ◽  
Sociocultural Factors ◽  
Childhood And Adolescence ◽  
Injury Surveillance System ◽  
Sport And Recreation

Context: In 2010, 8.6 million children were treated for unintentional injuries in American emergency departments. Child engagement in sports and recreation offers many health benefits but also exposure to injury risks. In this analysis, we consider possible developmental risk factors in a review of age, sex, and incidence of 39 sport and recreational injuries. Objective: To assess (1) how the incidence of 39 sport and recreational injuries changed through each year of child and adolescent development, ages 1 to 18 years, and (2) sex differences. Design Descriptive epidemiology study. Setting: Emergency department visits across the United States, as reported in the 2001–2008 National Electronic Injury Surveillance System database. Patients or Other Participants: Data represent population-wide emergency department visits in the United States. Main Outcome Measure(s) Pediatric sport- and recreation-related injuries requiring treatment in hospital emergency departments. Results: Almost 37 pediatric sport or recreational injuries are treated hourly in the United States. The incidence of sport- and recreation-related injuries peaks at widely different ages. Team-sport injuries tend to peak in the middle teen years, playground injuries peak in the early elementary ages and then drop off slowly, and bicycling injuries peak in the preteen years but are a common cause of injury throughout childhood and adolescence. Bowling injuries peaked at the earliest age (4 years), and injuries linked to camping and personal watercraft peaked at the oldest age (18 years). The 5 most common causes of sport and recreational injuries across development, in order, were basketball, football, bicycling, playgrounds, and soccer. Sex disparities were common in the incidence of pediatric sport and recreational injuries. Conclusions: Both biological and sociocultural factors likely influence the developmental aspects of pediatric sport and recreational injury risk. Biologically, changes in perception, cognition, and motor control might influence injury risk. Socioculturally, decisions must be made about which sport and recreational activities to engage in and how much risk taking occurs while engaging in those activities. Understanding the developmental aspects of injury data trends allows preventionists to target education at specific groups.

scholarly journals Kickball and Its Underappreciated Pediatric Injury Burden: An 18-Year Retrospective Epidemiological Study

2019 ◽  
Vol 7 (4) ◽  
pp. 232596711983589 ◽  
Author(s):  
Kevin Pirruccio ◽  
Daniel Weltsch ◽  
Keith D. Baldwin
Keyword(s):  
Emergency Departments ◽  
Injury Risk ◽  
Pediatric Population ◽  
The United States ◽  
Associated Injuries ◽  
Injury Surveillance System ◽  
Pediatric Injury ◽  
National Estimates ◽  
Male Patients ◽  
Injury Burden

Background: Kickball is a popular childhood game most frequently played during gym class or recess at schools throughout the United States (US). Despite this, the national health burden of injuries associated with kickball has never been explored in the US pediatric population. Purpose: To report national estimates and demographic characteristics of pediatric patients presenting to US emergency departments between 2000 and 2017 with kickball-associated injuries. Study Design: Descriptive epidemiology study. Methods: This study retrospectively analyzed the National Electronic Injury Surveillance System (NEISS) database (2000-2017) to identify annual cases of injuries associated with playing kickball presenting to US emergency departments in the pediatric population (age ≤18 years). Results: On average, 10,644 (95% CI, 8671-12,618) pediatric kickball-associated injuries presented to US emergency departments each year. There was no significant change in the number of injuries between the years 2000 (n = 10,331; 95% CI, 7781-12,881) and 2017 (n = 9407; 95% CI, 7233-11,582) ( P = .64). Patients frequently sustained sprains, strains, or muscle tears (34.4%; 95% CI, 32.4%-36.5%) and fractures (24.8%; 95% CI, 23.1%-26.5%); these injuries most commonly affected the ankle (13.7%; 95% CI, 12.2%-15.2%) and the fingers of the hand (17.1%; 95% CI, 15.5%-18.7%). The greatest proportion of injuries occurred in male patients (60.7%; 95% CI, 58.7%-62.7%) who were 10 to 12 years of age (44.8%; 95% CI, 43.0%-46.6%), with over half of kickball-associated injuries occurring at school (54.1%; 95% CI, 50.7%-57.5%). Conclusion: Despite kickball’s ubiquity as a schoolyard game, its associated injuries remain largely underappreciated. This is particularly unjustified when considering that the annual pediatric injury burden associated with playing kickball surpasses that of other sports acknowledged as carrying a high injury risk, such as martial arts or tennis.

A Nationwide Epidemiological Analysis of Finger Infections Presenting to Emergency Departments in the United States From 2012 to 2016

Hand ◽  
2020 ◽  
pp. 155894472091561
Author(s):  
Nicholas J. Lemme ◽  
Neill Y. Li ◽  
Edward J. Testa ◽  
Alexander S. Kuczmarski ◽  
Jacob Modest ◽  
...  
Keyword(s):  
United States ◽  
Emergency Departments ◽  
Hospital Admissions ◽  
The United States ◽  
Common Mechanism ◽  
Injury Surveillance System ◽  
Old Patients ◽  
Common Diagnosis ◽  
Common Causes ◽  
Old Men

Background: There is a paucity of literature exploring the epidemiology of finger infections presenting to emergency departments (EDs) on a national scale. The purpose of this study was to determine the national incidence of and risk factors for finger infections. Methods: Finger infections presenting to EDs between 2012 and 2016 were identified in the National Electronic Injury Surveillance System database. Finger infections were characterized by mechanism and type, with subanalyses for sex, race, and age. Results: Over this 5-year period, finger infections accounted for 80 519 visits to EDs in the United States. The annual incidence increased significantly from 4.4 per 100 000 person-years in 2012 to 6.2 in 2016. The 3 most common causes of finger infections were nail manicuring tools, knives, and doors. The most common diagnosis was finger cellulitis (46.3%). Significantly more men developed finger infections than women (relative risk of 1.4). The highest overall incidence was observed in 40- to 59-year-old men (7.8 per 100 000 person-years). Tenosynovitis resulted in the largest proportion of admissions (25%). Conclusions: We have demonstrated a rising incidence of finger infections presenting to EDs, with 40- to 59-year-old patients most at risk. The most common mechanism was the use of nail manicuring tools, such as nail clippers. Patient education may decrease finger infection incidence from these activities, and early detection of finger infections may be crucial to minimizing hospital admissions and invasive treatments.

Characteristics of Water Skiing-Related and Wakeboarding-Related Injuries Treated in Emergency Departments in the United States, 2001-2003

2005 ◽  
Vol 33 (7) ◽  
pp. 1065-1070 ◽  
Author(s):  
Sarah Grim Hostetler ◽  
Todd L. Hostetler ◽  
Gary A. Smith ◽  
Huiyun Xiang
Keyword(s):  
United States ◽  
Relative Risk ◽  
Confidence Interval ◽  
Emergency Departments ◽  
Brain Injuries ◽  
The United States ◽  
Body Region ◽  
Injury Surveillance System ◽  
Protective Gear ◽  
Body Regions

Background Water skiing and wakeboarding are popular sports with high potential for injury due to rapid boat acceleration, lack of protective gear, and waterway obstacles. However, trends in water skiing- and wakeboarding-related injuries in the United States have not been described using national data. Hypothesis The number of injuries, injury diagnoses, and body regions injured vary by sport. Study Design Descriptive epidemiology study. Methods Data regarding water skiing- and wakeboarding-related injuries presenting to 98 hospital emergency departments in the United States between January 1, 2001, and December 31, 2003, were extracted from the National Electronic Injury Surveillance System. Data included demographics, injury diagnosis, and body region injured. Results Data were collected for 517 individuals with water skiing-related injuries and 95 individuals with wakeboarding-related injuries. These injuries represent an estimated 23 460 water skiing- and 4810 wakeboarding-related injuries treated in US emergency departments in 2001 to 2003. Head injuries represented the largest percentage of injuries for wakeboarders (28.8% of all injuries) and the smallest percentage for water skiers (4.3%) (P <. 01; relative risk [95% confidence interval], 6.73 [3.89-11.66]). Analysis of injury diagnosis was consistent as wakeboarders had significantly more traumatic brain injuries (12.5% of all injuries) than did water skiers (2.4%) (P <. 05; relative risk [95% confidence interval], 5.27 [2.21-12.60]). Strains or sprains were the leading injury diagnoses for water skiing (36.3% of all injuries), and the majority (55.7%) were to the lower extremity. Lacerations were the most common diagnoses for wakeboarders (31.1% of all injuries), and the majority (59.6%) were to the face. Conclusion The analyses of water skiing- and wakeboarding-related injuries treated in US emergency departments in 2001 to 2003 highlight the differences in injury patterns for these 2 sports. The substantial number of head and facial injuries among wakeboarders underscores the need for research on the potential role of helmets or other protective gear to reduce these common injuries.

The burden of prosthetic hip dislocations in the United States is projected to significantly increase by 2035

2020 ◽  
pp. 112070002092361
Author(s):  
Kevin Pirruccio ◽  
Ajay Premkumar ◽  
Neil P Sheth
Keyword(s):  
United States ◽  
Emergency Departments ◽  
Hip Dislocation ◽  
The United States ◽  
Injury Surveillance System ◽  
Cross Sectional ◽  
Hip Implant ◽  
Total Hip ◽  
National Burden ◽  
Linear Regression Modeling

Introduction: Prosthetic hip dislocation is a common, costly complication of total hip arthroplasty (THA). Despite this, the national burden of prosthetic hip dislocations remains uncharacterised in the United States, especially pertaining to injuries occurring years after the index procedure. This study examines historical and projected national estimates of prosthetic hip dislocations presenting to U.S. emergency departments between 2000 and 2035. Methods: We conducted a cross-sectional, retrospective epidemiological study using narratives in the National Electronic Injury Surveillance System (NEISS) database (2000–2017) to identify an estimated 64,671 prosthetic hip implant dislocations presenting to U.S. emergency departments. Estimates for the prevalence of individuals living with a total hip implant were derived from the literature. Results: The national estimate of prosthetic hip dislocations presenting to U.S. emergency departments rose significantly ( p < 0.001) between 2000 ( n = 2395; 95% CI, 1264–3526) and 2017 ( n = 8094; 95% CI, 4276–11,912). These increases are likely driven by increased numbers of people living with THA overall, since between 2000 and 2017, the average incidence of prosthetic hip dislocation (0.14%; CI 0.08–0.21%) in patients living with hip implants has not changed significantly. Linear regression modeling (R2 = 0.7, p < 0.01) projected an increasing number of dislocations through 2035, predicting 10,446 national cases per year by this date. Conclusions: Driven by increases in THA, the annual volume of prosthetic hip dislocations presenting to U.S. emergency departments has increased significantly since 2000 and is projected to continue to rise sharply. Future advances in surgical technique, prosthesis design, and injury prevention policies aimed at decreasing the rate of THA dislocation would help alleviate this mounting national health burden.

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