Addressing health disparities using multiply imputed injury surveillance data.

BACKGROUND: Assessing disparities in injury is crucial for injury prevention and for evaluating injury prevention strategies, but efforts have been hampered by missing data. This study aimed to show the utility and reliability of the injury surveillance system as a trustworthy resource for examining disparities by generating multiple imputed companion datasets. METHODS: We employed data from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) for the period 2014-2018. A comprehensive simulation study was conducted to identify the appropriate strategy for addressing missing data limitations in NEISS-AIP. To evaluate the imputation performance more quantitatively, a new method based on Brier Skill Score (BSS) was developed to assess the accuracy of predictions by different approaches. We selected the multiple imputations by fully conditional specification (FCS MI) to generate the imputed companion data to NEISS-AIP 2014-2018. We further assessed health disparities systematically in nonfatal assault injuries treated in U.S. hospital emergency departments (EDs) by race and ethnicity, location of injury and sex. RESULTS: We found for the first time that significantly higher age-adjusted nonfatal assault injury rates for ED visits per 100,000 population occurred among non-Hispanic Black persons (1306.8, 95% Confidence Interval [CI]: 660.1 - 1953.5), in public settings (286.3, 95% CI: 183.2 - 389.4) and for males (603.5, 95% CI: 409.4 - 797.5). We also observed similar trends in age-adjusted rates (AARs) by different subgroups for non-Hispanic Black persons, injuries occurring in public settings, and for males: AARs of nonfatal assault injury increased significantly from 2014 through 2017, then declined significantly in 2018. CONCLUSIONS: Nonfatal assault injury imposes significant health care costs and productivity losses for millions of people each year. This study is the first to specifically look at health disparities in nonfatal assault injuries using multiply imputed companion data. Understanding how disparities differ by various groups may lead to the development of more effective initiatives to prevent such injury.

Workplace violence against healthcare workers using nationally representative estimates of emergency department data, 2015-2017.

INTRODUCTION: Workers in the healthcare industry are at increased risk for workplace violence. The goal of this analysis is to determine the rate of injuries healthcare workers incurred as a result of intentional violence by patients in the workplace. METHODS: Injuries linked to workplace violence that were treated in US emergency departments from 2015 to 2017 were identified using data from the National Electronic Injury Surveillance System-Occupational Supplement (NEISS-Work). All estimates and 95% confidence intervals were calculated using SAS® 9.4 Proc Survey to incorporate the stratified sample design of NEISS-Work. RESULTS: Approximately 1.14 million injuries to workers in the healthcare industry were treated in US hospital emergency departments between 2015 and 2017. Intentional injuries by another person accounted for 15% of these healthcare-related injuries. The results also showed that male healthcare workers' rate of injuries was 2.3 times higher than their female counterparts despite composing a smaller proportion of the workforce. Injury rates were highest among the less-than-25 age group, and decreased as healthcare workers' age increased. CONCLUSIONS: Workplace violence is a serious problem in today's healthcare settings that affects both employees and patient care. Although violence in the healthcare industry has been researched for decades, there has been an increase in violent incidents in this industrial sector. The disparity in injury rates by sex and age are areas of concern. Further research in these areas is necessary to understand the root causes of these incidents and inform violence prevention strategies.

A 20-year nationwide analysis of golf-associated eye injuries in the United States.

PURPOSE: Existing knowledge regarding golf-associated eye injuries (GEIs) is sparse. The purpose of this study was to characterize the types of GEIs, examine the mechanisms of injury, describe the characteristics of GEI victims, and determine the incidence of GEIs during the 2002-2021 period using the National Electronic Injury Surveillance System (NEISS) database. METHODS: Deidentified patient records were analyzed. Each GEI was assigned into a specific category of diagnosis, and the mechanism of injury was determined. National estimates were collected for each year, and simple linear regression modeling was used to determine trends over time. Furthermore, patient variables for sex, race, and age were analyzed. RESULTS: The NEISS query provided a total of 379 GEIs for analysis. GEIs were most common in adult males, with a decreasing, although not statistically significant, trend during this period (ß = -17.88, p = 0.110). Children were more likely to have a GEI caused by a golf club while adults were more likely to have one caused by the surrounding environment. Across all age groups, contusions and corneal abrasions were the most common GEIs, constituting 50.4% (190/377) of all eye injuries, followed by foreign body injuries (9%, 34/377) and then irritation/inflammation of the eye (8%, 30/377). The most common mechanism of injury among all players involved adverse interactions with the environment (37.7%, 142/377). CONCLUSION: Contradictory to existing literature, we show that minor GEIs are more common than severe ones. Rather than golf clubs or balls, environmental elements are the leading cause of GEIs.

Epidemiology of welding-associated ocular injuries.

PURPOSE: Currently, there exists a lack of recent epidemiological data concerning ocular injuries due to welding related activities. Our study analyzes trends in ocular injuries related to usage of welding equipment in the U.S. from 2010 to 2019. METHODS: Using the Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) Database, we queried data from January 1st 2010 to December 31st 2019 using the corresponding product code for welding equipment (896). Results were stratified by year, and standard descriptive statistical methods were applied to components including gender, age, diagnoses, and ED disposition. Circumstances leading up to the injuries were reviewed as well. RESULTS: Between 2010 and 2019 a total of 109,127 welding-associated ocular injuries occurred in the United States (95% CI, 86937-131,316). Estimates show a decreasing trend in cases from 13,415 (95% CI, 9979-16,851) in 2010 to 6944 (95% CI, 4868-9020) in 2019. A majority of cases occurred in men (98.2%) and in the 10-49 year age range (83.8%). 3.3% of cases involved spectators and 44% were bilateral. The top three ocular injury diagnoses were flash burns (62.1%), foreign body implantation (19.6%), and contusions/abrasions (11.1%). The number of radiation injuries trended down from 9286 in 2010 to 4023. With respect to a documented location, 38.9% occurred at home and 4.5% occurred in a school setting. Most patients (99.9%) were discharged from the ED; 0.1% were admitted to the hospital. CONCLUSIONS: The data suggests that number of ocular injuries related to welding has decreased significantly over the past 10 years. The most common injuries were radiation burns, foreign body disruption, and contusions/abrasions of the eye. Patients were predominantly men and between the ages of 10 and 49. Of note, almost half of all ocular injuries due to welding were bilateral, and 3% of ocular injuries were seen in spectators.

All-Terrain Vehicle-Related Emergency Department Visits: Interaction of Sex and Age, NEISS, 2019.

BACKGROUND: Epidemiologic patterns of all-terrain vehicle (ATV)-related emergency department (ED) visits by male and female individuals may vary at different ages. To our knowledge, this has not been researched previously. OBJECTIVE: The purpose of this study was to determine the interaction of sex and age differences in their association with ATV-related ED visits. METHODS: Data from the 2019 National Electronic Injury Surveillance System were extracted for ATV-related ED visits, including sex, age, race, location of crash, injured body part, and whether alcohol was involved. Descriptive statistics and logistic regression analyses were conducted. We modeled sex in separate multivariable models, adjusting for the same independent variables. RESULTS: There were an estimated 95,995 (unweighted n = 1999) ATV-related ED visits. There was a significant age-by-sex interaction in the association between ATV-related ED visits vs. other ED injuries, indicating that the effect of age on ATV-related ED visits differed by sex and vice versa. Overall, male individuals were 1.7 times as likely to have an ATV-related ED visit as female individuals. In the stratified analysis for female individuals, odds were substantially greater for girls younger than 18 years (adjusted odds ratio [AOR] 2.33; 95% confidence interval [CI] 1.61-3.69) and women aged 18-35 years (AOR 4.76; 95% CI 3.48-6.51) compared with woman older than 35 years. For men, odds were significant for ages 18-35 years (AOR 2.21; 95% CI 1.72-2.85) compared with men older than 35 years. CONCLUSIONS: As newer ATVs become more powerful and faster, there is a need to know who is at greatest risk for ATV-related ED visits to develop policies and safety measures.

Trends and epidemiology of radial head subluxation in the United States from 2004 to 2018.

BACKGROUND: Increased body mass may predispose children to a greater risk for radial head subluxation (RHS). Recent studies in the literature have reported a plateau in obesity prevalence among infants and toddlers. This study sought to examine recent epidemiological trends in RHS incidence from 2004 to 2018 using the National Electronic Injury Surveillance System database to determine how obesity patterns may affect RHS incidence. METHODS: The National Electronic Injury Surveillance System (NEISS) database was queried for patients 6 years of age or younger presenting with radial head subluxation between January 1, 2004 and December 31, 2018. Patient demographics, mechanisms of injury, and location of injury were recorded. RESULTS: An estimated total 253,578 children 6 years or younger were treated for RHS with 14,204 (95% CI = 8124-20,284) in 2004 to 21,408 (95% CI = 12,882-29,934) in 2018. The overall annual rate of RHS per 10,000 children ≤ 6 years was 6.03 (95% CI = 4.85-7.58). The annual rate of RHS per 10,000 children ≤ 6 years increased (m = 0.200, ß = 0.802, p < 0.001) from 5.18 (95% CI 2.96-7.39) in 2004 to 7.69 (95% CI = 4.63-10.75) in 2018. The most common mechanism associated with RHS was falls (39.4%) with 103,466 (95% CI 74,806-132,125) cases. Pulls accounted for the second most common mechanism of injury, accounting for 90,146 (95% CI 68,274-112,018) cases or 36.2%. Yearly RHS incidence was compared to obesity prevalence for ages 2-5 children provided by the National Health and Nutritional Examination Survey (NHANES) surveys. Changes in obesity prevalence may visually reflect RHS incidence trends, but no causality between obesity prevalence and RHS incidence could be confirmed. CONCLUSION: This study corroborated previous findings that falls and arm pulling contribute to the vast majority of RHS cases. The nonsignificant rise in RHS cases may reflect a possible plateau in obesity prevalence of children aged 2-5 years in recent years. LEVEL OF EVIDENCE: III.

Trends of hand injuries presenting to US emergency departments: A 10-year national analysis.

BACKGROUND: The purpose was to observe current incidence and trends of hand and wrist injuries presenting to U.S. emergency departments (EDs) over a decade. METHODS: The National Electronic Injury Surveillance System (NEISS) was queried for hand and wrist injuries from January 2009-December 2018. Descriptive analyses were used to report injury types to the hand and wrist. Incidence, age, gender, race, injury location, and type of injury were recorded. Linear regression analyses were used to assess changes in trends over time. A p value <0.05 was statistically significant. RESULTS: In total, 649,131 cases of hand and wrist injuries were identified in the NEISS from 2009 to 2018, correlating to 25,666,596 patients nationally. Incidence rates for finger, hand, and wrist were 450, 264, and 182 per 100,000 people. The estimated number of patients per year declined by 8.6% from 2009 to 2018. Male adults (aged 18-39) were the most frequent demographic. Total national estimates of hand (-8.2%; p = 0.001), wrist (-6.1%; p = 0.007), and finger (-9.9%; p < 0.001) injuries declined over the study period. The most common injuries were lacerations (36.5%), fractures (19.9%), strains/sprains (12.3%), and contusions/abrasions (12.1%) which significantly declined over the study period. The overall admission rate was 1.8%. CONCLUSIONS: The estimated annual number of hand/wrist injuries presenting to US EDs was 2.6 million with gradual decline over the decade. Hand injury registries could assist in quality improvement measures targeted toward increased efficiency and resource allocation and education.

Epidemiology and Characteristics of People with Injury Due to Volatile Substance Use to Induce Euphoria.

BACKGROUND: Unhealthy substance use is a public health challenge. Much of the focus of interventions is upon narcotics, stimulants, hallucinogens, central nervous system depressants, and alcohol. However, inhalants are also commonly used in an unhealthy manner and are under-recognized. The purpose of this study is to describe incident emergency department visits for volatile substance use to induce euphoria (VSUIE) injuries in the U.S. Methods: Data were obtained from the National Electronic Injury Surveillance System (NEISS) for the years 2015 to 2018. Descriptive frequencies, bivariate analyses using Rao-Scott Chi-Square, and multivariable logistic regression analyses were conducted to describe and examine the association between ED visits and VSUIE. Results: The estimated (weighted) number of VSUIE ED visits during 2015-2018 was 13,130 (95% Confidence Interval, CI: 8,383-17876; Coefficient of variation, CV = 0.18) and accounted for 0.02% of all ED visits. Males were more likely than females (p < .0001), and young adults (ages ≥18 to ≤ 35 years) were more likely than older adults to have a VSUIE ED visit (p <.0001). Conclusion: VSUIE ED visits occur more commonly in young adults than older adults and adolescents. The widespread use of volatile substances to induce euphoria is an under-reported public health issue with life-threatening consequences. Use of volatile substances by adolescents is a particular concern which needs attention and interventions to prevent its initiation.

Avocado-related knife injuries: Describing an epidemic of hand injury.

INTRODUCTION: Recent media reports have described knife injuries sustained while preparing avocados; however, this rise has not been reported in the literature. The purpose of this study is to describe, quantify, and trend emergency department (ED) encounters associated with avocado-related knife injuries. METHODS: The National Electronic Injury Surveillance System (NEISS) was queried for avocado-related knife injuries from 1998 to 2017. Patient demographic and injury data was collected and analyzed to describe trends in incidence, patient demographics, and injury patterns associated with an ED encounter for an avocado-related knife injury. RESULTS: There were an estimated 50,413 (95% Confidence Interval: 46,333-54,492) avocado-related knife injuries from 1998 to 2017. The incidence of avocado-related knife injuries increased over this time period (1998-2002 = 3143; 2013-2017 = 27,059). This increase correlated closely with a rise in avocado consumption in the U.S. (Pearson's Correlation: 0.934, p < 0.001) Women comprised 80.1% of injuries. The most common demographic injured were 23 to 39-year old females (32.7%), while the least common was males under the age of 17 (0.9%). Most ED presentations occurred on Saturdays (15.9%) or Sundays (19.9%) and the majority occurred during the months of April through July (45.6%). Injuries were much more common on the left (and likely non-dominant) hand. CONCLUSION: Avocado-related knife injuries are a preventable cause of hand injury. The incidence has risen significantly in recent years, possibly due to an increased consumption of avocados in the United States. Education on safe avocado preparation techniques and public safety initiatives, such as warning labels, could help prevent serious injuries in the future.

Injuries associated with hoverboard use: A review of the National Electronic Injury Surveillance System.

INTRODUCTION: Hoverboards have become popular since they became available in 2015. We seek to provide an estimate of the number of injuries in the United States for 2015 and 2016, and to evaluate differences between adult and pediatric injury complexes. METHODS: We performed a retrospective analysis of the National Electronic Injury Surveillance System (NEISS) from January 1, 2015 to December 31, 2016. Using the weighted design of the NEISS, a nationally representative sample could be determined. RESULTS: During the 2 year period, there were 24,650 hoverboard related injuries (95% confidence interval [Cl], 17,635-31,664) in the US. The average age was 20.9 years old. There were 15,134 pediatric injuries (95%CI 9980-20,287) and 9515 adult injuries (95%CI 7185-11,845). Female patients compromised 51.2% of the sample. The upper extremity was the most common region injured [13,080 (95% CI 8848-17,311)] and fracture was the most common type of injury [10,074 (95% CI 6934-13,213)]. Hoverboard injuries increased from 2416 (95% CL 575-4245) in 2015 to 22,234 (95% CI 16,446-28,020) in 2016. Pediatric patients were more likely to be injured in the upper and lower extremity when compared to their adult cohort (p = 0.0031). Six percent of the cohort [1575 (95% CI 665-2485)] sustained critical injuries with pediatric patients being at 1.46 times higher risk for life threatening injuries. CONCLUSION: Emergency department (ED) visits for hoverboard related injuries appear to be increasing. Pediatric patients are more at risk for hoverboard related injuries than adults and almost 6% of ED visits involved critical injuries, highlighting that hoverboards may be more dangerous than previously recognized.

A comparison of head injuries in male and female lacrosse participants seen in US emergency departments from 2005 to 2016.

INTRODUCTION: In the United States there has been a large increase in participation in lacrosse for both males and females. The purpose of this study was to analyze the number of head injuries, injury rates (calculated using the reported number of participants) and types of head injuries that are seen in emergency departments in the United States. METHODS: We compared injuries between male and female lacrosse participants. This was a retrospective study using a publicly available database produced by the US Consumer Product Safety Commission and information about lacrosse participation from US Lacrosse. RESULTS: A linear regression was performed and showed a positive correlation between number of head injuries to males and time from 2002 to 2010 (R2 = 0.823; p = 0.001). While the number of injuries to the head in female lacrosse participants was not significant. There was a negative correlation between the number of head injuries to males from 2010 to 2016 (R2 = 0.800; p = 0.007), but again, there was no significance for female injury count (R2 = 0.417; p = 0.117). Other significant differences between head injuries in males and females included the mechanism of injury and the type of injury recorded. CONCLUSION: The most recent data from 2010 to 2016, suggest that both males and females have had a decrease in injury rate. However the total number of female head injuries is not significantly decreasing and as the sport continues to grow there will likely be more total head injuries and visits to the emergency department.

Products and activities associated with non-fatal traumatic brain injuries in children and adolescents - United States 2010-2013.

Background: Traumatic brain injury (TBI) is prevalent in children and adolescents ages <1-19 years, yet we have limited understanding of consumer products that are associated with TBIs in children and adolescents of varying ages. To address this gap, we combined two data sources to investigate leading products and activities associated with TBIs in children and adolescents in different developmental age groups (i.e. <1, 1-4, 5-9, 10-14, and 15-19 years). Methods: We analysed data from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP), augmented with product information from the National Electronic Injury Surveillance System (NEISS), for the years 2010 through 2013. Results: From 2010 to 2013, children and adolescents aged <1-19 years accounted for 4.1 million non-fatal TBI-related emergency department visits. TBIs from home furnishings and fixtures, primarily beds, were highest among infants aged <1 year and children aged 1-4 years. TBIs from sports/recreation, especially bicycles and football, were highest among those aged 5-9 years, 10-14 years, and 15-19 years. Conclusions: The combined NEISS and NEISS-AIP data allow us to comprehensively examine products and activities that contribute to emergency department visits for TBIs in children and adolescents. Our findings indicate priority areas for TBI prevention and intervention.

Analysis of Electronic Cigarette-Related Injury Presenting to U.S. Emergency Departments, 2008-2017.

BACKGROUND: Several types of injuries associated with electronic cigarette malfunction have been reported in the literature since their introduction to the U.S. market in 2007. The traumatic consequences of electronic nicotine delivery system (ENDS) malfunction remain an under-researched topic. OBJECTIVES: Using information from a national database of emergency department (ED) visits, we sought to characterize the nature and frequency of ENDS injuries over a 10-year study period. METHODS: Archived information from the National Electronic Injury Surveillance System was accessed for the years 2008 to 2017. Incidents related to ENDS-related trauma were manually identified. Data extracted included patient demographics, injury type and location, and patient disposition. RESULTS: A total of 49 incidents were recorded during the years 2008 to 2017, including 18 cases in 2017, 25 cases in 2016, five cases in 2015, and one case in 2013. There were no identified ED visits for an e-cigarette-related burn or explosion prior to 2013. Using statistical weights, the estimated annual national incidence is 835 cases. Most of the injuries were thermal burns. The primary location of injury was in the lower extremity, followed by the upper extremity and hand. CONCLUSIONS: Our study demonstrates a significant increase in the number of ENDS-related injuries over the study period, particularly in males under the age of 45 years. This rise mirrors the growth of the ENDS market and this trend can be expected to continue. As the use of ENDS is expected to increase, physicians should become familiar with the nature of associated injuries.

Pediatric Cotton-Tip Applicator-Related Ear Injury Treated in United States Emergency Departments, 1990-2010.

OBJECTIVE: To evaluate the characteristics of children with cotton-tip applicator (CTA)-related ear injuries. STUDY DESIGN: Data on CTA-related ear injuries among children presenting to US emergency departments (EDs) from 1990 through 2010 were obtained from the National Electronic Injury Surveillance System. RESULTS: Between 1990 and 2010, an estimated 263 338 children aged <18 years were treated for CTA-related ear injuries in US hospital EDs. There was a nonsignificant increase in the annual number of injuries from 1990 through 2001 (78.2%) and a significant decrease from 2001 through 2010 (26.0%). Younger children sustained the highest rate of injury (32.2 per 100 000 for age 0-3 years). Ear cleaning was the most frequently documented circumstance at the time of injury (73.2%), and patients themselves were most commonly handling the CTA (76.9%). Foreign body sensation (39.2%) and bleeding (34.8%) were commonly documented reasons for visiting the ED. The presence of a foreign body (29.7%) and tympanic membrane perforation (25.3%) were common diagnoses. CONCLUSION: Most CTA-related injuries occurred with children themselves handling CTAs while cleaning their ears. Foreign body and tympanic membrane perforation were the most common associated diagnoses. Despite warnings against the use of CTAs in the ear canal and use of CTAs by children, these injuries continued to occur. Additional injury prevention strategies through further parent/caregiver and child education are warranted.

Parkour injuries presenting to United States emergency departments, 2009-2015.

BACKGROUND: Few studies have examined injuries resulting from practicing parkour. The current study provides details on more parkour-related emergency department visits than existed in the combined research literature. METHODS: Cross-sectional data from the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System were used to examine parkour-related injuries presenting to U.S. emergency departments over a seven year period. RESULTS: Most parkour injuries were reportedly caused by landing or from striking objects. Common diagnoses included fractures, sprains/strains, abrasions/contusions, and lacerations. More than half of reported injuries (57.7%) affected the patients' extremities. In this data, there appears to be a trend of increasing parkour injuries over time. Patients as young as 8years old have presented to emergency departments with parkour-related injuries in recent years. CONCLUSIONS: Given the relatively severe injuries obtained by youth participants, more research is needed to guide injury prevention efforts. Understanding the nature of parkour-related injuries may help inform prevention efforts. However, more systematic monitoring of participation in parkour and related injuries is needed.

Leash-related injuries associated with dog walking: an understudied risk for dog owners?

The topic of dog-walking injuries has recently gained notoriety through major media outlets in North America, including the Washington Post, NPR, and US News and World Report. In this review, we have compiled data from the main studies published in the past 2 decades that assess the incidence, demographics, and injury patterns related to dog leash walking. The available papers indicate that dog leash-related injuries have increased, particularly among women over 65. The most common causes of injury are dog-pulling behavior, which can result in tripping or tangling, with or without a fall, as well as upper extremity injuries. However, there is a lack of information regarding dog size, breed, training status, the type of leash used at the time of injury, and the role each factor may have in the incidence of injuries. The available data did not allow for evaluation of the impact of weather conditions on injury incidence. Information about the involved dogs, type of lead device, and weather conditions could be useful in identifying risk factors associated with dog ownership and guide prospective pet owners and their families to mitigate the risk of injuries.

Skiing Injuries in the US Pediatric Population: An Analysis of National Injury Trends and Mechanisms Between 2012 and 2022.

Background: While prevention protocols have been implemented, skiing-related musculoskeletal injuries and concussions continue to present to emergency departments in the United States. Previous literature has suggested the pediatric population may constitute up to 40% of skiing-related injuries. Purpose: To assess injury trends and the underlying mechanisms of skiing injuries in pediatric patients seen at emergency departments in the United States. Study Design: Descriptive epidemiology study. Methods: The National Electronic Injury Surveillance System (NEISS) was queried for pediatric (age ≤18 years) skiing injuries between January 1, 2012, and December 31, 2022. Injury mechanism, location, disposition, and diagnosis were recorded, and the statistical sample weight assigned by NEISS by hospital was used to calculate national estimates (NEs). Injury trends were evaluated with linear regression analysis. Results: Overall, 2951 pediatric skiing injuries were included (NE = 123,386). The mean age of the patients was 12.4 ± 3.5 years, with 61.3% of the injuries occurring in male patients. Impact with the ground was the most common injury mechanism (NE = 87,407; 70.8%). Fractures were the most common diagnosis (NE = 38,527, 31.2%), followed by strains/sprains (NE = 22,562, 18.3%), contusions/abrasions (NE = 16,257, 13.2%), and concussions (NE = 12,449, 10.1%). The lower leg was the most common fracture site (NE = 9509, 24.7%), followed by the shoulder (NE = 7131, 18.5%) and lower arm (NE = 5876, 15.3%). Analysis of annual injuries revealed no significant trend between 2012 and 2022 (P = .17), with fluctuations apparent throughout the study period. Significant decreases were seen in strains/sprains (P < .01) and contusions/abrasions (P < .01), but not in concussions (P = .57) or fractures (P = .70). Conclusion: Impacts with the snow/ground made up 70.8% of all injuries. Fractures were the most common injury diagnosis, followed by strains/sprains, with the lower leg being most frequently fractured. While strains/sprains and contusions/abrasions showed a significant decline, there were no significant trends in fractures and concussions between 2012 and 2022.

Epidemiologic Trends in Ophthalmic Trauma Related to Major Sports: An NEISS Study.

PURPOSE: To examine trends in ophthalmic trauma secondary to five major sports (baseball, soccer, tennis, football, basketball) and identify differences between patient characteristics and time period (pre-COVID vs COVID) of injury. METHODS: The National Electronic Injury Surveillance System was queried to extract cases related to the sports of interest from 2011-2020. Entries were analyzed by age, sex, diagnosis, location, and disposition, with narrative descriptions assessed to characterize the mechanism of injury and visual sequelae. National incidence was extrapolated and Pearson's ?2 and Fisher's exact tests were performed. RESULTS: Among 98,995 presentations, most involved male (83.5%) and pediatric patients (59.2%). Contusion/abrasion (57.3%) was the predominant diagnosis, with injuries primarily precipitated by contact with a ball (44.9%) and occurring in the recreational setting (49.0%). Visual sequelae were documented in 6.4% of injuries. Patients were commonly treated/examined and released (95.6%). Between sports, significant differences in diagnosis (p < .001), mechanism of injury (p < .001), location (p < .001), visual sequelae (p < .001), and disposition (p = .005) were observed. Stratification by age indicated significant differences in diagnosis, mechanism of injury, and location (all p < .001). Stratification by sex indicated significant differences in the mechanism of injury (p < .001) and visual sequelae (p = .04). Stratification by time period indicated significant differences in diagnosis (p = .002) and mechanism of injury (p = .001). CONCLUSION: There are notable differences in sports-related ocular injuries by patient characteristic, revealing important considerations for their clinical evaluation and the development of safety guidelines.

Lower Extremity Surfing Injuries Seen at United States Emergency Departments From 2002 to 2022.

Background: Surfing is an increasingly popular sport with a high propensity for both traumatic and atraumatic injuries. Purpose: To analyze the trends, etiologies, and diagnoses of lower extremity orthopaedic-related surfing injuries presenting to United States (US) emergency departments (EDs) within a 21-year study period. Study Design: Descriptive epidemiology study. Methods: The National Electronic Injury Surveillance System database was queried for data on lower extremity surfing injuries presenting to US EDs from January 1 to December 31, 2022. Data collected included year, injury mechanism, injury location, diagnosis, and disposition. The raw data were used to calculate national estimates (NEs) based on each hospital's assigned statistical sample weight. Linear regressions were performed to analyze annual trends. Results: A total of 776 lower extremity surfing injuries were included (NE = 49,218 injuries). The mean age of the patients was 29.4 ± 13.6 years. The most common injured areas were the foot (NE = 17,411; 35.4%), lower leg (NE = 8673, 17.6%), and knee (NE = 8139; 16.5%). The most common mechanism of injury was impact with board (NE = 17,144; 34.8%), and the most common fracture locations were the lower leg (NE = 1195; 29.5%), ankle (NE = 1594; 24.5%), and foot (NE = 1495; 23.0%). There were statistically significant decreases in weighted estimates for lower extremity surfing injuries by 108 per year (P < .001), for lacerations by 76 per year (P < .001), and for sprains by 18 per year (P = .01). Impact-with-board injuries decreased by 59 injuries per year (P < .001) and constituted 63.5% of lacerations and 12.1% of fractures. Only 3.9% of patients were admitted for hospitalization. Conclusion: There was a decreasing trend in lower extremity surfing injuries presenting to US EDs during the 21-year study period.