Methods of the National Athletic Treatment, Injury and Outcomes Network Surveillance Program (NATION-SP), 2014-2015 Through 2018-2019.

BACKGROUND: The National Athletic Treatment, Injury and Outcomes Network Surveillance Program (NATION-SP) was established in 2011 to provide a comprehensive appraisal of injuries sustained by high school student-athletes who received services from athletic trainers (ATs). The purpose of this article is to update the surveillance methods of the NATION-SP for data reported during the 2014-2015 through 2018-2019 academic years. SURVEILLANCE SYSTEM STRUCTURE: The NATION-SP used a rolling recruitment model to identify a convenience sample of US high schools with access to ATs. The ATs at participating institutions volunteered to contribute data via electronic medical records systems; common data elements were then pushed to and maintained by the Datalys Center for Sports Injury Research and Prevention. The ATs completed detailed reports on each injury, including the condition and circumstances. The treatments component was used to comprehensively assess the services provided to athletes by ATs. The outcomes companion component was developed to monitor patient-reported outcomes after athletic injury. SUMMARY: The NATION-SP continues to serve a critical purpose in informing injury-prevention and treatment efforts among high school athletes.

Injury Incidence in Youth, High School, and NCAA Men's Lacrosse.

BACKGROUND: We compared injury incidence and mechanisms among youth, high school (HS), and National Collegiate Athletic Association (NCAA) boys' and men's lacrosse athletes for the 2014-2015 to 2016-2017 lacrosse seasons. METHODS: Multiple injury surveillance systems were used to capture 21 youth boys', 22 HS boys', and 20 NCAA men's lacrosse team-seasons of data during the 2014-2015 to 2016-2017 seasons. Athletic trainers reported game and practice injuries and athlete exposures (AEs). Injuries included those occurring during a game and/or practice and requiring evaluation from an athletic trainer and/or physician. Injury counts, rates per 1000 AEs, and injury rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated. RESULTS: The injury rate in youth was higher than those reported in HS (10.3 vs 5.3 per 1000 AEs; IRR = 2.0; 95% CI: 1.6-2.4) and the NCAA (10.3 vs 4.7 per 1000 AEs; IRR = 2.2; 95% CI: 1.9-2.5). When considering time loss injuries only (restricted participation of ≥24 hours), the injury rate in youth was lower than those reported in HS (2.0 vs 2.9 per 1000 AEs; IRR = 0.7; 95% CI: 0.5-0.95) and the NCAA (2.0 vs 3.3 per 1000 AEs; IRR = 0.6; 95% CI: 0.4-0.8). The concussion rate in youth was higher than those in HS (0.7 vs 0.3 per 1000 AEs; IRR = 2.4, 95% CI: 1.1-5.2) and the NCAA (0.7 vs 0.3 per 1000 AEs; IRR = 2.1, 95% CI: 1.2-3.7). Injuries at the youth, HS, and NCAA levels were most commonly associated with stick contact, inflammatory conditions (including bursitis, tendonitis, and other unspecified inflammation), and noncontact mechanisms, respectively. CONCLUSIONS: Although the time loss injury rate was lowest in youth boys' lacrosse, the concussion rate was the highest. Injury prevention approaches should be specific to the mechanisms associated with each level of play (eg, equipment skill development in youth).