Pediatric Head Injuries and Deaths From Bicycling in the United States

Objective. To estimate the potential benefit of increasing bicycle helmet use among children and adolescents in the United States. Design. All bicycle-related deaths (Multiple Cause-of-Death Public Use Data Tapes, 1989 through 1992) and bicycle-related injuries treated in sampled emergency departments (National Electronic Injury Surveillance System, 1989 through 1993) were used to calculate traumatic brain injury-associated death and head injury rates per 1 000 000 US residents. Preventable injuries and deaths were estimated by calculating the populationattributable risk of head injury due to nonuse of bicycle helmets. Patients. US residents aged 0 through 19 years who were injured or who died as a result of a bicycle crash. Results. An average of 247 traumatic brain injury deaths and 140 000 head injuries among children and adolescents younger than 20 years were related to bicycle crashes each year in the United States. As many as 184 deaths and 116 000 head injuries might have been prevented annually if these riders had worn helmets. An additional 19 000 mouth and chin injuries were treated each year. The youngest age groups had the highest proportions of both head and mouth injuries. Conclusion. There continues to be a need to advocate for greater use of bicycle helmets, particularly among young children. Helmet design changes should be considered to prevent mouth injuries.

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Pediatric Traumatic Brain Injury in the United States: Rural-Urban Disparities and Considerations

Brain Sciences ◽

10.3390/brainsci10030135 ◽

2020 ◽

Vol 10 (3) ◽

pp. 135 ◽

Cited By ~ 2

Author(s):

John K. Yue ◽

Pavan S. Upadhyayula ◽

Lauro N. Avalos ◽

Tene A. Cage

Keyword(s):

Mental Health ◽

United States ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Healthcare Costs ◽

Motor Vehicle ◽

The United States ◽

Pubmed Database ◽

Pediatric Tbi

Introduction: Traumatic brain injury (TBI) remains a primary cause of pediatric morbidity. The improved characterization of healthcare disparities for pediatric TBI in United States (U.S.) rural communities is needed to advance care. Methods: The PubMed database was queried using keywords ((“brain/head trauma” OR “brain/head injury”) AND “rural/underserved” AND “pediatric/child”). All qualifying articles focusing on rural pediatric TBI, including the subtopics epidemiology (N = 3), intervention/healthcare cost (N = 6), and prevention (N = 1), were reviewed. Results: Rural pediatric TBIs were more likely to have increased trauma and head injury severity, with higher-velocity mechanisms (e.g., motor vehicle collisions). Rural patients were at risk of delays in care due to protracted transport times, inclement weather, and mis-triage to non-trauma centers. They were also more likely than urban patients to be unnecessarily transferred to another hospital, incurring greater costs. In general, rural centers had decreased access to mental health and/or specialist care, while the average healthcare costs were greater. Prevention efforts, such as mandating bicycle helmet use through education by the police department, showed improved compliance in children aged 5–12 years. Conclusions: U.S. rural pediatric patients are at higher risk of dangerous injury mechanisms, trauma severity, and TBI severity compared to urban. The barriers to care include protracted transport times, transfer to less-resourced centers, increased healthcare costs, missing data, and decreased access to mental health and/or specialty care during hospitalization and follow-up. Preventative efforts can be successful and will require an improved multidisciplinary awareness and education.

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A Tumble for a Cookie

Pediatric Traumatic Emergencies ◽

10.1093/med/9780190946623.003.0004 ◽

2020 ◽

pp. 33-40

Author(s):

Nancy Rixe

Keyword(s):

United States ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Glasgow Coma Scale ◽

The United States ◽

Minor Head Trauma ◽

Prediction Rules ◽

Coma Scale ◽

Ed Visits

Children with head injury account for more than 800,000 ED visits in the United States each year. Children with minor head trauma (Glasgow Coma Scale [GCS] of 14 or 15) constitute the majority of visits to the ED. Clinicians must balance the risk of cranial radiation with that of missing a clinically important traumatic brain injury (ciTBI). An understanding of the current validated clinical prediction rules for identifying low-risk children in whom CT is likely unnecessary is essential to ensure appropriate care of these children.

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Still Making Music: How Students with Traumatic Brain Injury Can Continue with Musical Activities

Music Educators Journal ◽

10.1177/0027432117697003 ◽

2017 ◽

Vol 103 (4) ◽

pp. 20-24

Author(s):

Patrick M. Bennington

Keyword(s):

United States ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Music Education ◽

Age Groups ◽

The United States ◽

School Age Children ◽

Music Listening ◽

School Age ◽

Children And Young Adults

Traumatic brain injury (TBI) is common in the United States. All age groups are at risk for TBI, but there is a larger occurrence among school-age children and young adults. No matter the severity of a student’s injury, he or she can benefit from music education, whether listening to music, singing, or performing on an instrument. Students can engage in music listening assignments that include selected pieces of music or music that an ensemble is currently rehearsing. For students with mild TBI who are able, performing music has also been shown to be beneficial.

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Emergency Department Visits From 2014 to 2018 for Head Injuries in Youth Non-Tackle Football Compared With Other Sports

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120975402 ◽

2021 ◽

Vol 9 (1) ◽

pp. 232596712097540

Author(s):

Jessica M. Zendler ◽

Ron Jadischke ◽

Jared Frantz ◽

Steve Hall ◽

Grant C. Goulet

Keyword(s):

United States ◽

Emergency Department ◽

Head Injury ◽

Head Injuries ◽

The United States ◽

Emergency Department Visits ◽

Head Region ◽

Cerebral Contusion ◽

Common Diagnosis ◽

Tackle Football

Background: Non-tackle football (ie, flag, touch, 7v7) is purported to be a lower-risk alternative to tackle football, particularly in terms of head injuries. However, data on head injuries in non-tackle football are sparse, particularly among youth participants. Purpose: To describe the epidemiology of emergency department visits for head injuries due to non-tackle football among youth players in the United States and compare the data with basketball, soccer, and tackle football. Study Design: Descriptive epidemiology study. Methods: Injury data from 2014 to 2018 were obtained from the National Electronic Injury Surveillance System database. Injury reports coded for patients aged 6 to 18 years and associated with basketball, football, or soccer were extracted. Data were filtered to include only injuries to the head region, specifically, the head, ear, eyeball, mouth, or face. Football injuries were manually assigned to “non-tackle” or “tackle” based on the injury narratives. Sports & Fitness Industry Association data were used to estimate annual sport participation and calculate annual injury rates per 100,000 participant-years. Results: A total of 26,770 incident reports from 2014 to 2018 were analyzed. For head region injuries in non-tackle football, the head was the most commonly injured body part, followed by the face; the most common diagnosis was a laceration, followed by concussion and internal injury (defined as an unspecified head injury or internal head injury [eg, subdural hematoma or cerebral contusion]). The most common contacting object was another player. The projected national rate of head region injuries was lowest for non-tackle football across the 4 sports. In particular, the projected rate of injuries to the head for non-tackle football (78.0 per 100,000 participant-years) was less than one-fourth the rates for basketball (323.5 per 100,000 participant-years) and soccer (318.2 per 100,000 participant-years) and less than one-tenth the rate for tackle football (1478.6 per 100,000 participant-years). Conclusion: Among youth in the United States aged 6 to 18 years who were treated in the emergency department for injuries related to playing non-tackle football, the most common diagnosis for injuries to the head region was a laceration, followed by a concussion. Head region injuries associated with non-tackle football occurred at a notably lower rate than basketball, soccer, or tackle football.

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Adult sports-related traumatic brain injury in United States trauma centers

Neurosurgical FOCUS ◽

10.3171/2016.1.focus15613 ◽

2016 ◽

Vol 40 (4) ◽

pp. E4 ◽

Cited By ~ 25

Author(s):

Ethan A. Winkler ◽

John K. Yue ◽

John F. Burke ◽

Andrew K. Chan ◽

Sanjay S. Dhall ◽

...

Keyword(s):

United States ◽

Traumatic Brain Injury ◽

Brain Injury ◽

The United States ◽

Mortality Rates ◽

Hospital Length Of Stay ◽

Health Concern ◽

Medical Complications ◽

Equestrian Sports ◽

Prolonged Hospital

OBJECTIVE Sports-related traumatic brain injury (TBI) is an important public health concern estimated to affect 300,000 to 3.8 million people annually in the United States. Although injuries to professional athletes dominate the media, this group represents only a small proportion of the overall population. Here, the authors characterize the demographics of sports-related TBI in adults from a community-based trauma population and identify predictors of prolonged hospitalization and increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from adults (age ≥ 18 years) across 5 sporting categories—fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged hospital length of stay (LOS), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α < 0.05, and the Bonferroni correction for multiple comparisons was applied for each outcome analysis. RESULTS From 2003 to 2012, in total, 4788 adult sports-related TBIs were documented in the NTDB, which represented 18,310 incidents nationally. Equestrian sports were the greatest contributors to sports-related TBI (45.2%). Mild TBI represented nearly 86% of injuries overall. Mean (± SEM) LOSs in the hospital or intensive care unit (ICU) were 4.25 ± 0.09 days and 1.60 ± 0.06 days, respectively. The mortality rate was 3.0% across all patients, but was statistically higher in TBI from roller sports (4.1%) and aquatic sports (7.7%). Age, hypotension on admission to the emergency department (ED), and the severity of head and extracranial injuries were statistically significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Traumatic brain injury during aquatic sports was similarly associated with prolonged ICU and hospital LOSs, medical complications, and failure to be discharged to home. CONCLUSIONS Age, hypotension on ED admission, severity of head and extracranial injuries, and sports mechanism of injury are important prognostic variables in adult sports-related TBI. Increasing TBI awareness and helmet use—particularly in equestrian and roller sports—are critical elements for decreasing sports-related TBI events in adults.

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Epidemiology of Isolated Versus Nonisolated Mild Traumatic Brain Injury Treated in Emergency Departments in the United States, 2006-2012

Journal of Head Trauma Rehabilitation ◽

10.1097/htr.0000000000000260 ◽

2017 ◽

Vol 32 (4) ◽

pp. E37-E46 ◽

Cited By ~ 27

Author(s):

Carol Cancelliere ◽

Victor G. Coronado ◽

Christopher A. Taylor ◽

Likang Xu

Keyword(s):

United States ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Emergency Departments ◽

The United States

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Firearm Injuries Affecting the Pediatric Population

PEDIATRICS ◽

10.1542/peds.89.4.788 ◽

1992 ◽

Vol 89 (4) ◽

pp. 788-790

Author(s):

Keyword(s):

United States ◽

Children And Adolescents ◽

Pediatric Population ◽

Age Groups ◽

Unintentional Injury ◽

The United States ◽

Male Adolescents ◽

Firearm Injuries ◽

Group 2 ◽

Developed Nations

In the United States approximately 30 000 people die from firearm injuries each year. Many more are wounded. In the mid 1980s, more than 3000 of the dead were children and adolescents aged 1 to 19 years.1 In 1989 nearly 4000 firearm deaths were among children 1 to 19 years of age, accounting for 12% of all deaths in that age group.2 All of these deaths or injuries affect other children because the victims who are killed or wounded are frequently relatives, neighbors, or friends. Comparison data for childhood age groups demonstrate that in 1987, 203 children aged 1 to 9 years, 484 children aged 10 to 14 years, and 2705 adolescents aged 15 to 19 years died as a result of firearm injuries.1 Firearm deaths include unintentional injuries, homicides, and suicides. Among the 1- to 9-year-olds, half of the deaths were homicides and half were unintentional. Among the 10- to 14-year-olds, one third of the deaths were homicides, one third were suicides, and one third were unintentional. Among the 15- to 19-year-olds, 48% were homicides, 42% were suicides, and 8% were unintentional.1 Firearm homicides are the leading cause of death for some US subpopulations, such as urban black male adolescents and young adults.3 Table 1 indicates how firearms contributed to the deaths of children and adolescents (homicides, suicides, and all causes) in 1987. Table 2 illustrates the unusual scale of firearm violence affecting young people in the United States compared with other developed nations.4 Firearm injuries are the fourth leading cause of unintentional injury deaths to children younger than 15 years of age in the US.5

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