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More than 280,000 kids treated for TBIs in EDs every year
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Pediatric sports- and recreation-related traumatic brain injuries, or SRR-TBIs, cause more than 280,000 visits to EDs throughout the United States, according to researchers from the CDC. Nearly half of these SRR-TBIs are caused by contact sports.
According to Kelly Sarmiento, MPH, a public health advisor in the CDC’s Division of Unintentional Injury Prevention’s traumatic brain injury team, and colleagues, previous research has suggested that children account for 70% of ED visits for SRR-TBIs.
The researchers examined all reported SRR-TBI cases presenting to American EDs between 2010 and 2016.
According to the researchers, an average of 283,000 SRR-TBIs among children aged younger than 18 years were treated in an emergency setting each year during the study period. Sarmiento and colleagues observed a “leveling off” in recent years. They theorized that this change beginning in 2012 may have occurred due to successful prevention efforts such as safety-minded rule changes in contact sports, declining participation in these sports or changes in care-seeking behaviors.
Male children had the highest rate of concussion, along with children aged 10 to 14 years and 15 to 17 years. Contact sports were the source of SRR-TBI for approximately 45% of all ED visits. When activity type was examined, football, bicycling, basketball, playground activities and soccer contributed to the highest number of ED visits for SRR-TBIs.
“Limiting player-to-player contact and rule changes that reduce risk for collisions are critical to preventing TBI in contact and limited-contact sports,” Sarmiento and colleagues wrote. “Development and testing of evidence-based interventions tailored for individual noncontact sports and recreation activities are warranted to ensure that children can stay healthy and active.” – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.
Perspective
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Christopher C. Giza, MD
ED visits for SRR-TBI have stabilized in recent years, but in males, the number of visits increased in 2010 to 2012 and then decreased in 2016. In females, the number of visits increased from 2010-2016.
Year-to-year comparisons are the most valid, assuming no change in data collection methods from 2010 to 2016. However, these data cannot determine the reasons for yearly changes. Increases may be due to better TBI recognition, more sport participation or more patients with TBIs going to EDs. Decreases may be due to improved safety or rules, less participation or reduced reporting of injuries.
These data cannot determine relative risks because they also reflect level of participation and where patients go for care. Although ED visits are likely to identify more severe injuries, we know these numbers underestimate the total because many patients with SRR-TBI may not go the ED.
Because of study limitations, it is possible for different and even sometimes opposite interpretations of these data. Nonetheless, it seems clear from this study that overall numbers of SRR-TBI ED visits have leveled off between 2010 and 2016, contrasting with earlier data showing steady increases. These data also show significant differences between males and females, including year-to-year changes, number of SRR-TBI visits and specific activities associated with SRR-TBI.
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