Characteristics of sports and recreation-related emergency department visits among school-age children and youth in North Carolina, 2010-2014

Katherine J Harmon; Scott K Proescholdbell; Johna Register-Mihalik; David B Richardson; Anna E Waller; Stephen W Marshall

doi:10.1186/s40621-018-0152-0

Characteristics of sports and recreation-related emergency department visits among school-age children and youth in North Carolina, 2010-2014

Inj Epidemiol. 2018 May 15;5(1):23. doi: 10.1186/s40621-018-0152-0.

Authors

Katherine J Harmon¹, Scott K Proescholdbell², Johna Register-Mihalik^{3

4

5}, David B Richardson⁶, Anna E Waller^{7

8}, Stephen W Marshall⁶

Affiliations

¹ Department of Epidemiology, University of North Carolina at Chapel Hill, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7435, USA. [email protected].
² Injury and Violence Prevention Branch, Chronic Disease and Injury Section, NC Division of Public Health, NC Department of Health and Human Services, 5505 Six Forks Road, Raleigh, NC, 27609, USA.
³ Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, 125 Fetzer Hall, CB# 8700, Chapel Hill, NC, 27599-8700, USA.
⁴ Matthew Gfeller Center, University of North Carolina at Chapel Hill, 2207 Stallings-Evans Sports Medicine Complex, CB# 8700, Chapel Hill, NC, 27599-8700, USA.
⁵ Injury Prevention Research Center, University of North Carolina at Chapel Hill, CVS Plaza, Suite 500, 137 East Franklin Street, CB# 7505, Chapel Hill, NC, 27599-7505, USA.
⁶ Department of Epidemiology, University of North Carolina at Chapel Hill, 2102B McGavran-Greenberg Hall, CB# 7435, Chapel Hill, NC, 27599-7435, USA.
⁷ Department of Emergency Medicine, University of North Carolina at Chapel Hill, Physicians Office Building, 170 Manning Dr., CB# 7594, Chapel Hill, NC, 27599-7594, USA.
⁸ Carolina Center for Health Informatics, University of North Carolina at Chapel Hill, Floor 1, 100 Market Street, CB #7597, Chapel Hill, NC, 27516, USA.

Abstract

Background: Sports and recreational activities are an important cause of injury among children and youth, with sports-related traumatic brain injuries (TBIs) being of particular concern given the developing brain. This paper reports the characteristics of sport and recreation-related (SR) emergency department (ED) visits among school-age children and youth in a statewide population.

Methods: This study included all injury-related visits made to all North Carolina 24/7 acute-care civilian hospital-affiliated EDs by school-age youth, 5-18 years of age, during 2010-2014 (N = 918,662). Population estimates were based on US decennial census data. Poisson regression methods were used to estimate incidence rates and rate ratios.

Results: During the five-year period, there were 767,075 unintentional injury-related ED visits among school-age youth, of which 213,518 (27.8%) were identified as SR injuries. The average annual absolute number and incidence rate (IR) of SR ED visits among school-age youth was 42,704 and 2374.5 ED visits per 100,000 person-years (95% confidence interval [CI], 2364.4-2384.6), respectively. In comparison to other unintentional injuries among school-age youth, SR ED visits were more likely to be diagnosed with an injury to the upper extremity (Injury Proportion Ratio [IPR] = 1.28; 95% CI, 1.27-1.29), the lower extremity (IPR = 1.14; 95% CI, 1.13-1.15), and a TBI or other head/neck/facial injury (IPR = 1.12; 95% CI, 1.11-1.13). Among ED visits made by school-age youth, the leading cause of SR injury was sports/athletics played as a group or team. The leading cause of team sports/athletics injury was American tackle football among boys and soccer among girls. The proportion of ED visits diagnosed with a TBI varied by age and sex, with 15-18 year-olds and boys having the highest population-based rates.

Conclusions: Sports and recreational activities are an important component of a healthy lifestyle, but they are also a major source of injury morbidity among school-age youth. Physical activity interventions should take into account sex and age differences in SR injury risk.

Keywords: Emergency department; Epidemiology; Injury surveillance; Traumatic brain injury; Youth sports.