Neck injuries presenting to emergency departments in the United States from 1990 to 1999 for ice hockey, soccer, and American football

Objective: To examine the number and rate of neck injuries in the community as a whole for ice hockey, soccer, and American football by analysing data from patients presenting to emergency departments in the United States from 1990 to 1999.     

Pediatric martial arts injuries presenting to Emergency Departments, United States 1990-2003.

Although an estimated 6.5 million United States (US) children aged 6-17 practiced a martial art in 2004, there have been no nationally representative studies comparing pediatric injuries among the three most popular disciplines, karate, taekwondo, and judo. Describe pediatric martial arts injuries presenting to a representative sample of US Emergency Departments (EDs) from 1990 to 2003. We reviewed all martial arts injuries captured by the US Consumer Product Safety Commission's (CPSC), National Electronic Injury Surveillance System (NEISS). An estimated 128,400 children 相似文献   

Epidemiology of lacrosse injuries treated at the United States emergency departments between 1997 and 2015

ABSTRACT

Lacrosse has gained substantial popularity across age groups in the past few decades, but epidemiologic sex differences of lacrosse injuries in emergency settings have not been well described. We characterized and described lacrosse-related injuries presenting to United States Emergency Departments (US EDs) using data from the National Electronic Injury Surveillance System (NEISS). From 1997 to 2015, 7,587 lacrosse-related injuries were treated at US EDs (national estimate of 256,358 injuries). Males accounted for 75.5% of injuries. Average age was 16.0 ± 5.0 (range 5–71) years. Sprains/strains (25.4%), contusions/abrasions (23.9%), and fractures (18.7%) were the most common diagnoses. Females sustained a higher proportion of sprains/strains (36.0%) than males (21.9%) (p< 0.01), while males sustained a higher proportion of fractures (injury proportion ratios [IPR]; 21.3% vs. 10.8%, p< 0.01). Similar proportions of concussions were observed (IPR; 6.1% in males, 6.2% among females). Differences in injury patterns may be secondary to differences in rules and equipment between the two sports.     

Epidemiology of fishing related upper extremity injuries presenting to the emergency department in the United States

Objective: Fishing injuries commonly affect the hands. The goal of this study was to quantify the incidence of fishing-related upper extremity injuries that present to emergency departments in the United States.

Methods: We examined the reported cases of fishing-related upper extremity injuries in the National Electronic Injury Surveillance System database. Analysis was performed based on age, sex and the type of injury reported.

Results: The national incidence of fishing-related upper extremity injuries was 119.6 per 1 million person-years in 2014. The most common anatomic site for injury was the finger (63.3%), followed by the hand (20.3%). The most common type of injury in the upper extremity was the presence of a foreign body (70.4%). The incidence of fishing-related upper extremity injuries in males was 200 per 1 million person-years, which was significantly higher than the incidence in females (41 per 1 million person-years).

Conclusion: The incidence of fishing-related upper extremity injuries that present to the Emergency Department was 120 per 1 million person-years. The incidence was significantly higher in males. With the widespread popularity of the activity, it is important for Emergency Physicians and Hand Surgeons to understand how to properly evaluate and manage these injuries.     

Non-fatal horse related injuries treated in emergency departments in the United States, 2001-2003

Objective

To characterise and provide nationally representative estimates of persons with non‐fatal horse related injuries treated in American emergency departments.

Methods

The National Electronic Injury Surveillance System All Injury Program (NEISS–AIP) is a stratified probability sample comprising 66 hospitals. Data on injuries treated in these emergency departments are collected and reported. NEISS–AIP data on all types (horseback riding and otherwise) of non‐fatal horse related injuries from 2001 to 2003 were analysed.

Results

An estimated 102 904 persons with non‐fatal horse related injuries (35.7 per 100 000 population) were treated in American emergency departments each year from 2001 to 2003 inclusive. Non‐fatal injury rates were higher for females (41.5 per 100 000) than for males (29.8 per 100 000). Most patients were injured while mounted on a horse (66.1%), commonly from falling or being thrown by the horse; while not mounted, injuries most often resulted from being kicked by the horse. The body parts most often injured were the head/neck region (23.2%), lower extremity (22.2%), and upper extremity (21.5%). The most common principal diagnoses were contusions/abrasions (31.4%) and fractures (25.2%). For each year that was studied, an estimated 11 502 people sustained traumatic brain injuries from horse related incidents. Overall, more than 11% of those injured were admitted to hospital.

Conclusions

Horse related injuries are a public health concern not just for riders but for anyone in close contact with horses. Prevention programmes should target horseback riders and horse caregivers to promote helmet use and educate participants about horse behaviour, proper handling of horses, and safe riding practices.     

Epidemiology of basketball injuries among adults presenting to ambulatory care settings in the United States.

OBJECTIVE: Little information exists that examines the epidemiology of injuries among adults who engage in sports and recreational activities. The purpose of this study is to examine basketball-related injuries among adults presenting to ambulatory settings in the United States. DESIGN: Retrospective review of medical records. SETTING: Emergency departments, outpatient departments, and physicians' offices in the United States. PATIENTS: Nationally representative sample of adults presenting to ambulatory care settings in the United States for treatment of injuries incurred while playing basketball. MAIN OUTCOME MEASURES: Body site injured, type of injury, ambulatory treatment site, and utilization of diagnostic testing. RESULTS: An annual average of 507,000 adults were treated in an ambulatory care setting for injuries related to playing basketball. The majority of these patients sought treatment in physicians' offices. Females had a much lower rate of visits (0.8/1000) for basketball-related injuries than males (5.7/1000); African American males had a rate 2.7 times higher than white males. The most common injuries were sprains and strains to the lower leg and/or ankle region and fractures of the hand, wrist, or fingers. Specific analyses of patients presenting to the emergency department diagnosed with sprain/strain injuries to the lower leg/ankle region revealed that 93% of these patients received an x-ray procedure. CONCLUSIONS: Basketball injuries constitute a significant portion of ambulatory medical care use in the United States each year, particularly among young adult males and African American males. Better surveillance of adult participation in sports and recreational activities is needed to better identify risk and protective factors for injuries.     

Epidemiology of meniscal injuries in US high school athletes between 2007 and 2013

Purpose

Knowledge of epidemiologic trends of meniscal injuries in young active populations is limited. Better awareness of injury patterns is a first step to lowering injury rates. Our hypothesis was that meniscal injuries in high school athletes would vary by gender, sport, and type of exposure.

Methods

During the 2007/2008 and 2012/2013 academic years, a large nationally disperse sample of US high schools reported athlete exposure and injury data for 22 sports by having certified athletic trainers complete an internet-based data collection tool.

Results

One thousand and eighty-two meniscal injuries were reported during 21,088,365 athlete exposures for an overall injury rate of 5.1 per 100,000 athlete exposures. The overall rate of injury was higher in competition (11.9) than practice (2.7) (RR = 4.4; 95 % CI 3.9–5.0), and 12/19 sports showed significantly higher injury rates in competition compared to practice. Of all injuries, 68.0 % occurred in boys, yet among the gender-comparable sports of soccer, basketball, track and field, lacrosse, and baseball/softball injury rates were higher for girls than boys (5.5 and 2.5, respectively, RR = 2.2; 95 % CI 1.8–2.7). Contact injury represented the most common mechanism (55.9 %). Surgery was performed for the majority of injuries (63.8 %), and 54.0 % of athletes had associated intra-articular knee pathology.

Conclusions

Meniscal injury patterns among high school athletes vary by gender, sport, and type of exposure. Our study is clinically relevant because recognition of distinct differences in these injury patterns will help drive evidence-based, targeted injury prevention strategies and efforts.

Level of evidence

III.

     

A comparison of pediatric freestyle and Greco-Roman wrestling injuries sustained during a 2006 US national tournament

The purpose of this study was to compare the epidemiology of freestyle and Greco-Roman wrestling injuries sustained during a 2006 United States (US) national tournament. A prospective injury surveillance study was conducted at the US 2006 ASICS/Vaughan Cadet and Junior National Championships. There were 83 freestyle- and 55 Greco-Roman-related injuries sustained, with the rate of injury per 1000 athlete-matches higher in freestyle (7.0) compared with Greco-Roman (4.6) wrestling [Rate ratio (RR)=1.51, 95% confidence interval (CI): 1.07–2.12]. Compared with Greco-Roman wrestling, there was a greater proportion of knee injuries in freestyle wrestling [injury proportion ratio (IPR)=4.17, 95% CI: 1.30–13.41]. In GrecoRoman wrestling, there were greater proportions of elbow (IPR=9.11, 95% CI: 1.13–73.59) and head/face/neck (IPR=1.72, 95% CI: 1.10–2.67) injuries and a greater proportion of concussions (IPR=1.95, 95% CI: 0.92–4.12), although the latter was statistically insignificant. Greco-Roman wrestlers sustained a greater proportion of injuries from being driven into the mat (IPR=2.97, 95% CI: 1.72–5.14). There were no statistically significant differences in injury outcome by wrestling style. The differing injury rates and patterns of injury between freestyle and Greco-Roman wrestling are likely due to the different rules between these styles that allow lower leg attacks in freestyle wrestling and encourage the use of throws in Greco-Roman wrestling.     

非结构化放射报告中关键测试值和信息的自动化提取:1990—2011年间930万份报告的分析

目的确定我们健康档案中930万份放射报告中关键的放射诊断结果的比例,使用自动文本分类算法识别这些文档的信息,评价信息中的重要结果的政策影响。材料与方法本研究符合HIPAA原则,获得单位伦理委员会的批准。将已验证的文本提取算法应用于930万份放射诊断报告的数据库,识别特定重要结果的准确度平均超过90%。从而确定1990—2011年间重要结果和信息的比例。结果从1990—2011年,所有文档内的重要结果信息呈增长趋势。在1990年,19.0%的报告确定含重要信息,而2010年此数值为72.4%。1997年后,重要信息文档呈线性增长趋势并持续至2011年(P<0.001)。从1990—2011年,文档信息最多的是急性睾丸扭转(70.6%)和异位妊娠(65.4%),最少的是不明原因的腹腔内积气(29.5%)和异位导管(30.4%)。在2010—2011年,放射科医生不倾向于诊断异位的气管插管和肠道导管(2010年58.56%,2011年57.50%)和不明原因的腹腔内积气(2010年59.57%,2011年75.51%)。他们诊断最多的是异位妊娠(2010年94.12%,2011年93.48%)和急性阑尾炎(2010年86.87%,2011年84.31%)。结论信息文档内关键结果呈增长趋势,1997年后开始呈线性增长并且持续至2011年。这种增长趋势正好开始于政策实行之前,这表明其他因素例如放射科医生意识的提高也发挥了一定作用。     

A profile of Australian football injuries presenting to sports medicine clinics

Most of the published data describing Australian football injuries is from hospital emergency departments and elite injury surveillance studies. There is a lack of good information about injuries to players at the lower levels of participation and those not severe enough to warrant hospital treatment. This study describes the profile of Australian football injuries that present to sports medicine clinics for treatment. New sports injury cases, presenting to five metropolitan Melbourne sports medicine clinics during a 12 month period in 1996-1997, were recorded through the Sports Medicine Injury Surveillance project. Both the patient and treating health professional provided personal and injury details. Australian football accounted for 29% of the 6479 recorded injury cases. The majority of injured players were male (99%) and from adult, community leagues (78%); the mean age was 23 years. Competition accounted for 78% of injuries and 72% of injured players presented for treatment to a sports physician/medical practitioner. Body contact accounted for half of all injuries and the most common injuries were medial ligament sprains of the knee (7%), lateral ligament sprains of the ankle (6%) and anterior cruciate ligament injuries (4%). In conclusion, sports medicine clinics treat a wide variety of football injuries and appear to be a good source of data about injuries to non-elite participants.     

Epidemiology, pathomechanics, and prevention of athletic injuries to the cervical spine

Athletic injuries to the cervical spine associated with quadriplegia most commonly occur as a result of axial loading. Whether it be a football player striking an opponent with the top or crown of his helmet, a poorly executed dive into a shallow body of water where the subject strikes his head on the bottom, or a hockey player pushed into the boards head first, the fragile cervical spine is compressed between the rapidly decelerated head and the continued momentum of the body. Appropriate rule changes recognizing this mechanism have resulted in a reduction of football quadriplegia by two-thirds. Presumably, educational efforts designed to inform the public of the dangers of diving would have a similar effect. The predominance of the axial loading mechanism is not as clearly defined in trampoline and minitrampoline injuries. However, both of these devices are dangerous when used in the best of circumstances, and their use has no place in recreational, educational, or competitive gymnastics. The emergence of severe cervical spine injuries resulting from ice hockey is recognized. Methods, based on sound scientific evidence, to modify the games so as to prevent these injuries are lacking.     

Problems in blood alcohol testing of severely injured drivers brought to emergency departments in Japan

Breath alcohol tests are widely used to control DUI (driving under the influence) in Japan. However, this test is not applied to injured drivers transported to emergency hospitals. In such cases, BAC (blood alcohol concentration) testing should be done to prove DUI. In this paper, we tried to clarify two important issues on the BAC testing in Japan using a questionnaire survey and experiments about contamination of antiseptic ethanol. First, we have described the doctor's dilemma with DUI cases; our present questionnaire survey showed that the police often request the doctor to volunteer blood samples of the suspected drunk drivers brought to emergency hospitals since they have not been granted the right to order blood sampling in Japan. Then, doctors face a serious dilemma whether comply with the police request or not, resulting in widely different responses. Secondly, we have estimated the effects of antiseptic ethanol routinely used as a dermal antiseptic on the BAC tests. Our present experiments showed that uptake of ethanol can occur under certain conditions. Given the actual conditions outlined in the questionnaire, there seem to be a definite risk of ethanol contamination in BAC testing. Obviously, the time has come to discuss problems in BAC testing of injured drivers brought to emergency hospitals in Japan.     

Transperineal US: alternative technique to improve visualization of the presenting fetal part

Transperineal ultrasound (TPU) was used as an alternative imaging technique to evaluate the anatomy of the presenting part in 27 second- and third-trimester fetuses when transabdominal ultrasound (US) images were suboptimal. Use of TPU improved visualization of the distal fetal spine in 20 of 21 breech cases, providing sufficient information regarding bone anatomy to rule out splaying of the posterior elements. In addition, the intact skin surface overlying the distal spine, not seen at transabdominal US, was well demonstrated at TPU in 18 of these fetuses. TPU was used to improve assessment of intracranial anatomy in six cases with a cephalic presentation in which the fetal head was located low in the maternal pelvis and could not be adequately visualized with the transabdominal technique. In one of these cases, TPU offered improved visualization of anencephaly. Use of TPU should be considered to optimize visualization of the presenting fetal part when results at transabdominal US are suboptimal and the poorly seen part overlies the maternal cervix.