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Waltzman D, Sarmiento K, Zhang X, Miller GF. Estimated prevalence of helmet use while bicycling, rollerblading, and skateboarding among middle school students in selected U.S. States- Youth Behavior Risk Survey, 2013-2019. JOURNAL OF SAFETY RESEARCH 2023; 87:367-374. [PMID: 38081708 PMCID: PMC10714050 DOI: 10.1016/j.jsr.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/04/2022] [Accepted: 08/09/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Helmet use helps prevent severe and fatal head and brain injuries from bicycle, rollerblade, and skateboard crashes. This study explores the prevalence of self-reported helmet use among middle school students while bicycling, skateboarding, and rollerblading. METHODS Data from the Middle School Youth Risk Behavior Survey (YRBS) for selected states were analyzed. Self-reported prevalence (frequency) of helmet use while bicycling, rollerblading, or skateboarding and other variables (sex, grade level, and race/ethnicity) are reported. RESULTS The overall prevalence of rarely or never wearing a helmet while bicycling among middle school students in selected states was 68.6%; decreasing from 71.7% in 2013 to 67.1% in 2019. The overall prevalence of rarely or never wearing a helmet while rollerblading or skateboarding in middle school students in selected states was 74.6%; decreasing from 76.4% in 2013 to 73.5% in 2019. Students in 7th and 8th grade and students of non-Hispanic race/ethnicity had significantly higher odds of rarely or never wearing a helmet while bicycling or while rollerblading and skateboarding than students in 6th grade and non-Hispanic White students. CONCLUSIONS While helmet use among middle school students improved over time, overall helmet use during bicycling, rollerblading, and skateboarding remained low. These estimates illustrate the continued call for universal implementation of helmet use efforts among kids using established strategies. PRACTICAL APPLICATIONS Future research on helmet use among youth who rollerblade and skateboard, as well as multi-pronged efforts to promote helmet use among middle schoolers who bicycle, skateboard, and rollerblade (inclusive of education, helmet distribution, and social marketing techniques, as well as the provision of helmets at no-cost) may be beneficial for addressing perceived risks for injury and other barriers.
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Affiliation(s)
- Dana Waltzman
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, United States.
| | - Kelly Sarmiento
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, United States
| | - Xinjian Zhang
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, United States
| | - Gabrielle F Miller
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, United States
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Sorenson TJ, Rich MD, Deitermann A, Gotlieb R, Garcia N, Barta RJ, Schubert W. Likelihood of Craniofacial Injury and Hospitalization with Alcohol Use While Skateboarding and Scootering. Craniomaxillofac Trauma Reconstr 2023; 16:34-38. [PMID: 36824181 PMCID: PMC9941291 DOI: 10.1177/19433875211069219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Study Design: We designed a cross-sectional epidemiologic study to evaluate the influence of substance use on craniofacial injuries in a population of skateboard and scooter users. Objective: The primary outcome of our study was craniofacial injury. The secondary outcome was hospitalization. Methods: We report a cross-sectional study of patients reported to the National Electronic Injury Surveillance System (NEISS) from January 1, 2019, to December 31, 2020, in the United States. Patients were included in our study if they were evaluated in the emergency department (ED) for a skateboard- or scooter-related injury. Results: There were over 5396 total patients who presented to a NEISS-participating ED after skateboard- or scooter- related trauma during the study period. There were 1136 patients with a craniofacial injury (primary endpoint), and patients under the influence of alcohol or drugs had greater odds of experiencing a craniofacial injury than those not under the influence (odds ratio [OR]: 4.16, 95% confidence interval [CI]: 3.24-5.32, P < .0001). Four hundred-thirty patients were hospitalized (secondary endpoint), and patients under the influence had greater odds of being hospitalized than those not under the influence (OR: 2.83, 95% CI: 2.04-3.91, P < .0001). Conclusions: Alcohol and drug use while skateboarding or scootering drastically increases the likelihood of craniofacial injury and subsequent hospitalization and should be avoided whenever possible. The importance of wearing a helmet while operating these devices cannot be overstated.
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Affiliation(s)
| | - Matthew D. Rich
- Division of Plastic Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | | | - Rachael Gotlieb
- Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Nicholas Garcia
- Division of Plastic Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Ruth J. Barta
- Division of Plastic Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
- Department of Plastic and Hand Surgery, Regions Hospital, Saint Paul, MN, USA
| | - Warren Schubert
- Division of Plastic Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
- Department of Plastic and Hand Surgery, Regions Hospital, Saint Paul, MN, USA
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3
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Mitchao DP, Lewis M, Jakob D, Benjamin ER, Demetriades D. Skateboard head injuries: Are we making progress? Injury 2022; 53:1658-1661. [PMID: 35063260 DOI: 10.1016/j.injury.2021.12.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 11/20/2021] [Accepted: 12/11/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Skateboarding is a popular sport and U.S. trauma centers care for a significant number of skateboard-related injuries (SRIs). However, injury prevention strategies are still underdeveloped. This study was designed to compare the epidemiology, type, and location of skateboard injury as well as the use and influence of protective gear over two time periods. METHODS This is a retrospective National Trauma Data Bank study including all patients with SRIs between 2007and 2016. Study groups were divided into two 5-year periods: 2007-2011 and 2012-2016. The incidence and severity of traumatic brain injury (TBI), as well as the compliance and effectiveness of protective gear and skate parks, was assessed in various age groups in the two study periods using univariable and multivariable analyses. Univariable analysis was used to compare the two study periods, logistic regression analysis was performed to identify independent predictors of head injury and severe TBI. RESULTS 24,903 patients presented with SRIs: 10,594 from 2007 to 2011 and 14,309 from 2012 to 2016. Helmet use was low in both periods (5.7% and 5.4% respectively). The incidence of severe TBI (head AIS≥3) did not change significantly during the two periods (31.6% vs. 30.8%, p = 0.162). In children with severe TBI, there was no significant difference in helmet use across all ages, (10.4% vs. 11.5%, p = 0.467; 6.4% vs. 6.5%, p = 0.753; 4.2% vs. 3.7%, p = 0.201, respectively) with the lowest usage in the older than 16 years age group. On logistic regression, male gender (OR 1.526, 95% CI 1.372-1.698, p<0.001) was associated with increased odds of severe TBI, while helmet use (OR 0.534, 95% CI 0.455-0.627, p<0.001) and injuries at skate parks (OR 0.584, 95% CI 0.541-0.630, p<0.001), near home (OR 0.465, 95% CI 0.418-0.518, p<0.001), and public buildings (OR 0.386, 95% CI 0.440-0.541, p<0.001) were associated with reduced odds of severe TBI. CONCLUSIONS Helmet use in patients with SRIs is low in all pediatric age groups. Helmet use and skate parks are protective against severe TBI. Older age children and male gender are at increased risk of severe TBI after skateboard-related injuries, and more targeted preventive education and legislation are needed.
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Affiliation(s)
- Delbrynth P Mitchao
- Division of Trauma and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, U.S
| | - Meghan Lewis
- Division of Trauma and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, U.S..
| | - Dominik Jakob
- Division of Trauma and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, U.S
| | - Elizabeth R Benjamin
- Division of Trauma and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, U.S
| | - Demetrios Demetriades
- Division of Trauma and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, U.S
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O'Connor M, Mehta S, Milanaik R. The Lack of Helmets in Olympic Skateboarding-Skating Into Dangerous Territory. JAMA Pediatr 2022; 176:224-225. [PMID: 34842916 DOI: 10.1001/jamapediatrics.2021.4600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Mary O'Connor
- Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success
| | - Setu Mehta
- Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success
| | - Ruth Milanaik
- Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success
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Turbans vs. Helmets: A Systematic Narrative Review of the Literature on Head Injuries and Impact Loci of Cranial Trauma in Several Recreational Outdoor Sports. Sports (Basel) 2021; 9:sports9120172. [PMID: 34941810 PMCID: PMC8703542 DOI: 10.3390/sports9120172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/03/2021] [Accepted: 12/15/2021] [Indexed: 12/28/2022] Open
Abstract
When in public, faith-based mandates require practising Sikh men to wear a turban which may not be covered by hats or caps. This makes it impossible for practising Sikhs to wear helmets and other protective headwear, mandatory in many countries and facilities for engagement in recreational pursuits (e.g., skiing) and on adventure outdoor recreation camps mandatorily run for school groups. The result is often social exclusion and ostracisation in the case of school children. Despite studies into the efficacy of protective helmets in some recreational outdoor activity settings, virtually nothing is known about the protective potential of turbans. This paper systematically reviews the extant literature on head injuries in several recreational outdoor activities and sports sectors (aerial, water, winter, wheeled and animal-based sports) and finds that the extant literature is of limited value when trying to understand the spatial distribution of trauma on the cranial surface. As the data do not permit to make inferences on the protective potential of turbans, future systematic, evidence-based epidemiological studies derived from hospital admissions and forensic examinations are required. Failure to do so perpetuates social exclusion and discrimination of religious grounds without an evidentiary basis for defensible public health measures.
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Rod JE, Oviedo-Trespalacios O, King M. A retrospective registry analysis of the transport-related health burden of wheeled recreational devices in Queensland, Australia. Aust N Z J Public Health 2021; 46:208-215. [PMID: 34648211 DOI: 10.1111/1753-6405.13162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/01/2021] [Accepted: 08/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Evaluate injury patterns from wheeled recreational devices (WRD) in the public space and explore risk factors for hospital admission. METHOD A cross-sectional analysis of WRD injury prevalence and risk factors for hospital admissions was conducted using data from the Queensland Injury Surveillance Unit (QISU) database for 2007 to 2017. Descriptive statistics and a log-binomial regression model were used to calculate adjusted relative risk for hospital admission. RESULTS Most WRD injury in the public space was related to stand-alone WRD injury events such as falls, with few reported WRD users being hit by vehicles from 2007 to 2017. Stand-alone WRD injury events had a higher independent risk of hospital admissions when injured in the head/neck/face (RR 2.08, 95%CI 1.6 to 2.8, p<0.001), and when the injury was a fracture (RR 2.57, 95%CI 2.1 to 3.3, p<0.001) or a brain injury (RR 3.19, 95%CI 2.5 to 4.1, p<0.001). CONCLUSION Head, brain and facial injuries and fractures are leading preventable factors for hospital admissions due to WRD injury. These types of injuries generate a preventable burden to the health system. Implications for public health: The results support the need to consider legislation regarding mandatory helmet use for non-motorised WRD when used on public roads and footpaths, while further research is conducted. This strategy could reduce the long-term health outcomes associated with head, face and brain injury in young commuters.
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Affiliation(s)
- J E Rod
- Centre for Accident Research and Road Safety Queensland (CARRS-Q), Queensland University of Technology.,Centre for Future Mobility, Queensland University of Technology
| | - Oscar Oviedo-Trespalacios
- Centre for Accident Research and Road Safety Queensland (CARRS-Q), Queensland University of Technology.,Centre for Future Mobility, Queensland University of Technology
| | - Mark King
- Centre for Accident Research and Road Safety Queensland (CARRS-Q), Queensland University of Technology.,Centre for Future Mobility, Queensland University of Technology
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Harbrecht A, Hackl M, Leschinger T, Uschok S, Wegmann K, Eysel P, Müller LP. What to expect? Injury patterns of Electric-Scooter accidents over a period of one year - A prospective monocentric study at a Level 1 Trauma Center. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2021; 32:641-647. [PMID: 34061254 PMCID: PMC8167386 DOI: 10.1007/s00590-021-03014-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/28/2021] [Indexed: 11/18/2022]
Abstract
Purpose E-scooters are a new type of urban transportation utilized in Germany since June 2019, primarily in larger cities in the context of sharing offers. Such electrically operated standing scooters can be driven at a maximum speed of 20 km/h. A helmet is not mandatory. The aim of this prospective study is to document the injury patterns over the period of 1 year and compare our findings with already available data. Methods Over a period of 1 year (July 2019–July 2020), data on E-scooter-related accidents treated at a level 1 trauma center of a major German city were prospectively documented. Injury patterns were analyzed, and epidemiological data evaluated. Results Fifty-nine (35 female, 24 male) accidents were included in the observation period. Mean age of accident victims was 30.03 years (± 9.32). Alcohol influence at the time of accident was detected in 9 cases (15.25%). Many of the accident victims suffered multiple injuries. Most of the injuries were upper (50.84%) and lower extremity (47.45%) as well as craniofacial injuries (62.71%). A helmet was not worn in any of the cases. Conclusion In the year following their introduction, E-scooter-related accidents have led to an additional burden on the emergency capacities of the involved University Hospital, especially in the summer months of 2019. Protective equipment is de facto not worn. Injuries to the extremities, head, and face were most common. None of the accident victims died. This coincides with results from other major cities in national and international comparison. A more intensive education about injury consequences of unprotected E-scooter use and the discussion of a possible obligation to wear a helmet and further protection equipment for the extremities should take place.
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Affiliation(s)
- Andreas Harbrecht
- Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
| | - Michael Hackl
- Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Tim Leschinger
- Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Stephan Uschok
- Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Kilian Wegmann
- Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Peer Eysel
- Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Lars P Müller
- Faculty of Medicine and University Hospital, Center for Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
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8
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Szczygielski J, München D, Ketter R, Ràkàsz L, Schulz-Schaeffer W, Oertel J. Head Injury without Head Blow? A Rare Case of Subdural Hematoma Associated with Minute Arachnoid Cyst in a Teenage Skater. J Neurol Surg A Cent Eur Neurosurg 2021; 82:604-610. [PMID: 33540449 DOI: 10.1055/s-0040-1721021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Skateboarding has been reported to cause diverse kinds of injuries, including head trauma. However, the risk of brain injury without direct blow to the head seems to be underestimated. In particular, the impact of the inertial forces related to the vigorous character of skateboarding tricks is not sufficiently recognized. CASE DESCRIPTION In our report, we demonstrate a case of chronic subdural hematoma developing without previous blow to the head in a 17-year-old skater bearing small frontal convexity arachnoid cyst. CONCLUSION Based on the described case, the possibility of acceleration and angular forces related to skate park leisure activities resulting in subdural hematoma needs to be discussed. This risk should be critically appraised in patients carrying arachnoid cyst as a malformation predisposing to develop subdural bleeding.
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Affiliation(s)
- Jacek Szczygielski
- Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany.,Instutute of Neuropathology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany.,Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
| | - Dorothea München
- Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - Ralf Ketter
- Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - Lukas Ràkàsz
- Department of Neurosurgery, Queens Elisabeth Hospital Birmingham, Birmingham, United Kingdom
| | - Walter Schulz-Schaeffer
- Instutute of Neuropathology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - Joachim Oertel
- Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany
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9
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McIntosh AS, Patton DA, McIntosh AG. Managing head injury risks in competitive skateboarding: what do we know? Br J Sports Med 2020; 55:836-842. [PMID: 33032991 DOI: 10.1136/bjsports-2020-102013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The broad objective of this paper is to inform policy, practice and research regarding the management of head injury risks in competitive skateboarding. The main motivation for the current study was the question of mandating helmet use in competitive skateboarding. The specific aims are to present current knowledge on (A) head injury risks in skateboarding, (B) preliminary biomechanical data on falls and head injury risks in a selection of competitive skateboarding events similar to those planned for the Summer Olympics, (C) standards for skateboard-styled helmets and (D) impact performance of helmets commonly used in skateboarding. METHODS A narrative review of the published literature on head injuries in skateboarding was conducted. Videos of skateboarding competitions from Vans Park Professional League, Street League Skateboarding and Dew Tour were reviewed to describe crashes and falls. Standards databases including the International Organization for Standardization (ISO), British Standards Institution (BSI), Snell, United States Consumer Product Safety Commission (CPSC) and American Society for Testing and Materials (ASTM) were searched for skateboarding-styled helmet standards. A sample of helmets considered suitable for skateboarding was tested in standard impact tests. RESULTS The majority of previous literature focused on the paediatric population in a recreational setting with little data from competitive skateboarding. Head injuries comprised up to 75% of all injuries and helmet use was less than 35%. Video analysis identified high rates of falls and crashes during competitive skateboarding, but also a capacity for the athletes to control falls and limit head impacts. Less than 5% of competitive skateboarders wore helmets. In addition to dedicated national skateboard helmet standards, there are several national standards for skateboard-styled helmets. All helmets, with the exception of one uncertified helmet, had similar impact attenuation performance; that is, at 0.8 m drop height, 114-148 g; at 1.5 m, 173-220 g; and at 2.0 m, 219-259 g. Impact performance in the second impact was degraded in all helmets tested. CONCLUSION Helmets styled for skateboarding are available 'off the shelf' that will offer protection to the head against skull fractures and intracranial injuries in competitive skateboarding. There is an urgent need to commence a programme of research and development to understanding and control head injury risks.
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Affiliation(s)
- Andrew Stuart McIntosh
- School of Engineering and ACRISP, Edith Cowan University, Joondalup, WA, Australia .,McIntosh Consultancy and Research, Sydney, NSW, Australia
| | - Declan Alexander Patton
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
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Partiali B, Oska S, Barbat A, Sneij J, Folbe A. Injuries to the Head and Face From Skateboarding: A 10-Year Analysis From National Electronic Injury Surveillance System Hospitals. J Oral Maxillofac Surg 2020; 78:1590-1594. [PMID: 32504565 DOI: 10.1016/j.joms.2020.04.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/27/2020] [Accepted: 04/27/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To estimate the incidence of patients presenting to emergency departments (EDs) as a result of facial trauma sustained from skateboarding. PATIENTS AND METHODS The National Electronic Injury Surveillance System (NEISS) database was queried for skateboard-related head and face fractures, contusions, abrasions, and lacerations from 2009 through 2018. We identified 2,519 reported injuries, extrapolating to a national incidence of 100,201 injuries. Fractures accounted for 14.1% of these visits. There were 355 ED visits for fractures, extrapolating to an estimated 11,893 visits nationally. Entries were tabulated for demographic information, fracture type, mechanism of injury, and disposition. RESULTS Patients sustaining injury to the head and face were aged 16 years, on average, and predominantly male patients (85.9%). Most patients sustaining fractures were male patients (87.9%), with a mean age of 18 years. The most common fracture types included unspecified skull fractures (31%), nasal fractures (29%), and mandibular fractures (18%). The most common mechanism of injury was falling off the skateboard while riding (76.9%). Collisions with motor vehicles also accounted for a substantial proportion of the injuries (7.3%). CONCLUSIONS A substantial number of ED visits were a result of skateboarding-related facial trauma. Given the neurologic outcomes of head trauma and functional consequences of facial fractures, especially among adolescents, our findings suggest that injury prevention programs and more aggressive helmet use may be necessary to reduce morbidity and hospitalization.
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Affiliation(s)
- Benjamin Partiali
- Medical Student, Oakland University William Beaumont School of Medicine, Rochester, MI.
| | - Sandra Oska
- Medical Student, Oakland University William Beaumont School of Medicine, Rochester, MI
| | - Antonio Barbat
- Medical Student, Oakland University William Beaumont School of Medicine, Rochester, MI
| | - Joseph Sneij
- Physician, Associates In Family Practice, Sterling Heights, MI
| | - Adam Folbe
- Academic-Vice Chair, Division of Otolaryngology Head and Neck Surgery, Department of Otolaryngology, William Beaumont Hospital, Royal Oak, MI
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11
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Characteristics and Injury Patterns in Electric-Scooter Related Accidents-A Prospective Two-Center Report from Germany. J Clin Med 2020; 9:jcm9051569. [PMID: 32455862 PMCID: PMC7290505 DOI: 10.3390/jcm9051569] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/08/2020] [Accepted: 05/19/2020] [Indexed: 11/25/2022] Open
Abstract
Since the introduction of rental E-scooters in Germany in mid-June 2019, the safety of this new means of transport has been the subject of extensive public debate. However, valid data on injuries and usage habits are not yet available. This retrospective two-center study included a total of 76 patients who presented to the emergency department following E-scooter-related accidents. The mean age was 34.3 ± 12.4 years and 69.7% of the patients were male. About half of the patients were admitted by ambulance (42.1%). Fractures were found in 48.6% of patients, and 27.6% required surgical treatment due to a fracture. The upper extremities were the most commonly affected body region, followed by injuries to the lower extremity and to the head and face. Only one patient had worn a helmet. In-hospital treatment was necessary for 26.3% of the cases. Patients presented to the emergency department mainly during the weekend and on-call times. This is the first report on E-scooter-related injuries in Germany. Accidents with E-scooters can cause serious injuries and, therefore, represent a further burden to emergency departments. The use of E-scooters appears to be mostly recreational, and the rate of use of protective gear is low.
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12
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Rodríguez-Rivadulla A, Saavedra-García MÁ, Arriaza-Loureda R. Skateboarding Injuries in Spain: A Web-Based Survey Approach. Orthop J Sports Med 2020; 8:2325967119884907. [PMID: 32232064 PMCID: PMC7082873 DOI: 10.1177/2325967119884907] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: The inclusion of skateboarding in the Tokyo 2020 Olympic Games reinforces this activity as a sport. As the number of skateboarders around the world and the difficulty of skateboarding maneuvers continue to increase, the number of skateboarding injuries may also rise. Thus, there is a need for more comprehensive investigations into the practice habits and injuries of skateboarders. Purpose: To describe the sports habits and skateboarding injuries of a sample of skateboarders in Spain. Study Design: Descriptive epidemiology study. Methods: A web-based survey was shared among skateboarders in Spain. The survey collected data related to sports habits, skateboarding practice habits, and injury history. Comparisons between subgroups of sex, age, and experience were also conducted. Results: The survey was completed by 197 participants (89.3% male) with a mean age of 24.4 ± 7.1 years and a mean experience of 9.7 ± 7.2 years. Most respondents (87.8%) reported not participating in any type of skateboarding-specific physical training program. Only 27.4% took part in skateboarding competitions, with a larger number of respondents younger than 18 years participating in competitive events. The mean number of sessions per week was 3.3 ± 1.7, and the mean length of sessions was 3.3 ± 1.5 hours. The majority of participants (87.8%) reported having suffered injuries (n = 323) as a result of skateboarding, mainly affecting the lower limbs (69.7%). The most common injury type was a ligament sprain (39.6%), especially of the ankle (39.3%). This injury was also reported as the most likely to recur (70.1%). A large number of injuries (54.2%) were considered severe (ie, >21 days to recover). Most injuries occurred while skateboarding gaps or stairs, including any type of a jump that involved a difference in height between the take-off and landing surfaces (25.7%). Female participants accounted for a larger number of ligament sprains than expected, and experienced skateboarders were more likely to suffer more severe injuries and head/trunk injuries. Conclusion: Respondents to this survey were mainly young male adults who practiced skateboarding recreationally. Respondents of different sexes, ages, and experiences demonstrated different habits and injury patterns. The greater number of severe injuries highlights the need for injury surveillance in skateboarding to inform better prevention and rehabilitation practices.
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Affiliation(s)
- Adrián Rodríguez-Rivadulla
- Department of Physical Education and Sports, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Miguel Ángel Saavedra-García
- Department of Physical Education and Sports, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Rafael Arriaza-Loureda
- Department of Physical Education and Sports, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
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Kobayashi LM, Williams E, Brown CV, Emigh BJ, Bansal V, Badiee J, Checchi KD, Castillo EM, Doucet J. The e-merging e-pidemic of e-scooters. Trauma Surg Acute Care Open 2019; 4:e000337. [PMID: 31565677 PMCID: PMC6744075 DOI: 10.1136/tsaco-2019-000337] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 11/03/2022] Open
Abstract
Introduction Since their release in 2017, standing electric motorized scooters (eScooters) have risen in popularity as an alternative mode of transportation. We sought to examine the incidence of injury, injury patterns, prevalence of helmet and drug and alcohol use in eScooter trauma. Methods This was a multi-institutional retrospective case series of patients admitted for injuries related to operation of an eScooter following the widespread release of these devices in September 2017 (September 1, 2017 to October 31, 2018). Demographics, drug and alcohol use, helmet use, admission vitals, injuries, procedures, hospital and intensive care unit length of stay (LOS), death, and disposition were analyzed. Results 103 patients were admitted during the study period, and monthly admissions increased significantly over time. Patients were young men (mean age 37.1 years; 65% male), 98% were not wearing a helmet. Median LOS was 1 day (IQR 1-3). 79% of patients were tested for alcohol and 48% had a blood alcohol level >80 mg/dL. 60% of patients had a urine toxicology screen, of which 52% were positive. Extremity fractures were the most frequent injury (42%), followed by facial fractures (26%) and intracranial hemorrhage (18%). Median Injury Severity Score was 5.5 (IQR 5-9). One-third of patients (n=34) required an operative intervention, the majority of which were open fixations of extremity and facial fractures. No patients died during the study. The majority of patients were discharged home (86%). Conclusion eScooter-related trauma has significantly increased over time. Alcohol and illicit substance use among these patients was common, and helmet use was extremely rare. Significant injuries including intracranial hemorrhage and fractures requiring operative intervention were present in over half (51%) of patients. Interventions aimed at increasing helmet use and discouraging eScooter operation while intoxicated are necessary to reduce the burden of eScooter-related trauma. Level of evidence Level IV.
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Affiliation(s)
- Leslie M Kobayashi
- Department of Surgery, University of California San Diego Health System, San Diego, California, USA
| | - Elliot Williams
- Department of Surgery, University of California San Diego Health System, San Diego, California, USA
| | | | | | | | | | | | - Edward M Castillo
- Emergency Medicine, University of California San Diego, San Diego, California, USA
| | - Jay Doucet
- Department of Surgery, University of California San Diego Health System, San Diego, California, USA
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14
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Russell KW, Katz MG, Short SS, Scaife ER, Fenton SJ. Longboard injuries treated at a level 1 pediatric trauma center. J Pediatr Surg 2019; 54:569-571. [PMID: 30593338 DOI: 10.1016/j.jpedsurg.2018.10.098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 09/09/2018] [Accepted: 10/28/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Recreation on longboards is gaining in popularity. The purpose of this study is to detail the injury patterns, treatment and management of children with longboarding injuries seen at a level 1 pediatric trauma center. METHODS A retrospective review using our trauma registry from 2006 to 2016 of pediatric patients who sustained injuries while riding a longboard. RESULTS Of 12,920 injured children, 64 (0.5%) were treated for injuries that occurred while riding a longboard. Median age was 14.5 years (IQR 13.6, 15.4) and 84% were male. Fifty-one (80%) suffered a traumatic brain injury (TBI) including 32 intracranial hemorrhages (ICH), 17 concussions, and 31 skull fractures. Seven (11%) were wearing helmets. Three patients required neurosurgical intervention. Extremity fractures were the most common reason for surgery. Ninety-six percent of patients were admitted to the hospital with a median length of stay of 1 day (IQR 1, 3). All children survived to discharge. Compared with skateboard injuries during the same period, TBI, ICH, concussion, and skull fractures were all greater. CONCLUSIONS TBI ranging from concussion to ICH requiring craniotomy is common in children injured while riding a longboard, and greater than rates after skateboarding injuries. Extremity fracture was the most common reason for operative intervention. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Katie W Russell
- Division of Pediatric Surgery, University of Utah School of Medicine, Salt Lake City, UT.
| | - Micah G Katz
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT
| | - Scott S Short
- Division of Pediatric Surgery, University of Utah School of Medicine, Salt Lake City, UT
| | - Eric R Scaife
- Division of Pediatric Surgery, University of Utah School of Medicine, Salt Lake City, UT
| | - Stephen J Fenton
- Division of Pediatric Surgery, University of Utah School of Medicine, Salt Lake City, UT
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15
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Abstract
Skateboarding has become an international action sport attractive to young people. For this reason, skateboarding has been promoted by some researchers as important for encouraging young people to become more physically active. However, skateboarding is also considered to be inherently dangerous by the medical and broader community and as a result skateboarding is banned in many places. This paper reviews scientific literature on the features, outcomes and risk factors related to skateboarding injuries. Findings suggest that while skateboarding injuries can be severe, skateboarding is not as dangerous as it might appear if appropriate risk management steps are taken. Skateboarding should be encouraged as a worthy physical activity and local communities should consider providing specialised, supervised spaces for young people to practice this sport.
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Affiliation(s)
- Francesco Feletti
- a Department of Diagnostic Imaging , Ausl della Romagna, Santa Maria delle Croci Hospital , Ravenna , Italy.,b Department of Electronics , Information and Bioengineering, Politecnico di Milano University , Milano , Italy
| | - Eric Brymer
- c Institute of Sport Physical Activity and Leisure , Leeds Beckett University , Leeds , UK
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16
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Le Sage N, Tardif PA, Prévost ML, Batomen Kuimi BL, Gagnon AP, Émond M, Chauny JM, Frémont P. Impact of wearing a helmet on the risk of hospitalization and intracranial haemorrhage after a sports injury. Brain Inj 2018; 32:1766-1772. [PMID: 30234396 DOI: 10.1080/02699052.2018.1512717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Despite their reported protective effect against the occurrence of head injuries, helmets are still used inconsistently in sports in which they are optional. We aimed to assess the impact of helmet use on the risk of hospitalization and intracranial haemorrhage for trauma occurring during sport activities. METHODS Retrospective cohort of all patients who presented themselves, over an 18-month period, at the emergency department of a tertiary trauma centre for an injury sustained in a sport or leisure activity where the use of a helmet is optional. Impact of helmet use was assessed using multivariable regression analyses (relative risks, RR). RESULTS Among the 1,022 patients included in the study, half were cyclists and 40% were skiers or snowboarders. A total of 40 % of patients wore a helmet at the time of injury, 18% had a head injury, 16% were hospitalized and 13% of patients with a head injury had an intracranial haemorrhage. Among all patients, no association was observed between hospital admission and helmet use. However, helmet use in patients with a head injury was associated with significant reductions in the risks of hospitalization (RR 0.41 [95% CI: 0.22-0.76]) and intracranial haemorrhage (RR 0.28 [95% CI: 0.11-0.71]). CONCLUSIONS Results suggest that, in recreational athletes who sustain a head injury, helmet use is associated with a reduced risk of hospitalization (all sports) and intracranial haemorrhage (cyclists).
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Affiliation(s)
- Natalie Le Sage
- a Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs , Centre de recherche du CHU de Québec, Université Laval , Québec , QC , Canada.,b Département de Médecine Familiale et Médecine d'Urgence, Faculté de Médecine , Université Laval , Québec , QC , Canada.,c Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), Public Health Agency of Canada , Hôpital de l'Enfant-Jésus , Québec , QC , Canada
| | - Pier-Alexandre Tardif
- a Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs , Centre de recherche du CHU de Québec, Université Laval , Québec , QC , Canada
| | - Marie-Laurence Prévost
- a Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs , Centre de recherche du CHU de Québec, Université Laval , Québec , QC , Canada
| | - Brice Lionel Batomen Kuimi
- a Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs , Centre de recherche du CHU de Québec, Université Laval , Québec , QC , Canada
| | - Ann-Pier Gagnon
- a Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs , Centre de recherche du CHU de Québec, Université Laval , Québec , QC , Canada.,c Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), Public Health Agency of Canada , Hôpital de l'Enfant-Jésus , Québec , QC , Canada
| | - Marcel Émond
- a Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs , Centre de recherche du CHU de Québec, Université Laval , Québec , QC , Canada.,b Département de Médecine Familiale et Médecine d'Urgence, Faculté de Médecine , Université Laval , Québec , QC , Canada.,d Centre d'Excellence sur le Vieillissement de Québec, Centre de recherche sur les soins et les services de première ligne de l'Université Laval , Québec , QC , Canada
| | | | - Pierre Frémont
- f Département de réadaptation, Faculté de Médecine , Université Laval , Québec , QC , Canada
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17
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Weber CD, Horst K, Nguyen AR, Lefering R, Pape HC, Hildebrand F. Evaluation of severe and fatal injuries in extreme and contact sports: an international multicenter analysis. Arch Orthop Trauma Surg 2018; 138:963-970. [PMID: 29675749 DOI: 10.1007/s00402-018-2935-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Indexed: 01/21/2023]
Abstract
PURPOSE The participation in extreme and contact sports has grown internationally, despite the significant risk for major and multiple injuries. We conducted this multicenter study to evaluate sport-specific injury patterns and mechanisms, to characterize individuals at risk and to identify possible approaches for prevention. METHODS We compared demographic data, severity and patterns of injuries; and the pre- and in-hospital management from an international population-based prospective trauma database (TraumaRegister DGU®). The registry was screened for sport-related injuries, and only patients with major injuries [Injury Severity Score (ISS) ≥ 9 points] related to extreme or contact sports activities were included (January 1, 2002, to December 31, 2012). Parameters were compared for different types of sports activities: (1) Airborne sports, (2) Climbing, (3) Skateboarding/Skating, (4) Contact sports. The following countries participated: Germany, Austria, Switzerland, Finland, Slovenia, Belgium, Luxembourg, and The Netherlands. Statistical analyses were performed with SPSS (Version 22, IBM Inc., Armonk, New York). RESULTS A total of 278 athletes were identified within the study period and classified into four groups: Airborne sports (n = 105) were associated with the highest injury severity (ISS 22.4 ± 14.6), followed by climbing (n = 35, ISS 16.5 ± 12), skating (n = 67, ISS 15.2 ± 10.3) and contact sports (n = 71, ISS 10.4 ± 9.2). Especially high falls resulted in a significant rate of spinal injuries in airborne activities (68.6%, p < 0.001) and in climbing accidents (45.7%). Skating was associated with the highest rate of loss of consciousness (LOC) at scene (27.1%), the highest pre-hospital intubation rate (33.3%), and also the highest in-hospital mortality (15.2%, p < 0.001), related to major head injuries. CONCLUSIONS Extreme and contact sports related major injuries predominantly affect young male athletes. Especially skaters are at risk for debilitating and lethal head injuries. Individuals recognizing sport-specific hazards might modify their risk behavior. LEVEL OF EVIDENCE Descriptive Epidemiologic Study, Level II.
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Affiliation(s)
- Christian D Weber
- Department of Orthopaedics and Trauma, RWTH Aachen University, Pauwels street 30, 52074, Aachen, Germany. .,Olympic Center Rhineland, Aachen, Germany.
| | - Klemens Horst
- Department of Orthopaedics and Trauma, RWTH Aachen University, Pauwels street 30, 52074, Aachen, Germany
| | - Anthony R Nguyen
- Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, Australia
| | - Rolf Lefering
- Committee on Emergency Medicine, Intensive Care and Trauma Management (Sektion NIS) of the German Trauma Society (DGU), Cologne, Germany
| | | | - Frank Hildebrand
- Department of Orthopaedics and Trauma, RWTH Aachen University, Pauwels street 30, 52074, Aachen, Germany
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Sadeghian H, Nguyen B, Huynh N, Rouch J, Lee SL, Bazargan-Hejazi S. Factors Influencing Helmet Use, Head Injury, and Hospitalization Among Children Involved in Skateboarding and Snowboarding Accidents. Perm J 2017; 21:16-161. [PMID: 28406787 DOI: 10.7812/tpp/16-161] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CONTEXT Up to 75% of skateboarders and snowboarders admitted to the hospital sustain head injuries. It is unclear why not all children and teenagers wear helmets while snowboarding and skateboarding given the protection they afford. OBJECTIVES To report on the prevalence of, and factors associated with, skateboarding and snowboarding in injured children and to explore factors that influence helmet use, head injury, and hospitalization in this sample. DESIGN A cross-sectional study of skateboard- and snowboard-associated injuries from 2003 to 2012 among individuals younger than age 18 years using National Electronic Injury Surveillance System (NEISS) data from approximately 100 hospitals. MAIN OUTCOME MEASURES Helmet use, head injury, and hospitalization. RESULTS Of 1742 patients in the study, 852 (48.9%) and 890 (51.1%) were skateboarders and snowboarders, respectively. Overall, 907 (52.1%) did not use helmets, and 704 (40.4%) sustained head injuries. Multiple logistic regression analysis showed that age, race/ethnicity, location of boarding, and engaging in skateboarding influenced helmet use. Sex, race/ethnicity, helmet use, and skateboarding predicted head injury. Age, sex, skateboarding, and head injury predicted hospital admission. CONCLUSION Statistically significant differences exist in helmet use, head injury, and hospitalization rates between skateboarders and snowboarders. Our findings suggest that injury prevention and outreach programs are needed to increase helmet use and reduce the risk of head injury and hospitalization in skateboarders and other at-risk groups. Further studies are needed to clarify the association between race/ethnicity and helmet use among skateboarders and snowboarders.
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Affiliation(s)
- Homa Sadeghian
- Physician conducting research at the Neurovascular Research Laboratory in the Department of Radiology at the Massachusetts General Hospital and Harvard Medical School in Boston.
| | - Brian Nguyen
- General Surgery Chief Resident in the Department of Surgery at the Los Angeles County Harbor-University of California Los Angeles Medical Center in Torrance. bnguyen7.@BIDMC.harvard.edu
| | - Nhan Huynh
- General Surgery Research Resident in the Division of Pediatric Surgery at the University of California Los Angeles.
| | - Joshua Rouch
- General Surgery Resident in the Division of Pediatric Surgery at the University of California Los Angeles.
| | - Steven L Lee
- Professor of Clinical Surgery and Pediatrics at the David Geffen School of Medicine at the University of California Los Angeles; Chief of Pediatric Surgery and Associate Director of the General Surgery Residency at the Los Angeles County Harbor-University of California Los Angeles Medical Center in Torrance.
| | - Shahrzad Bazargan-Hejazi
- Professor of Medical Sociology at the Charles R Drew University of Medicine and Science, College of Medicine and a Professor of Psychiatry at the University of California Los Angeles David Geffen School of Medicine.
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19
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Winkler EA, Yue JK, Burke JF, Chan AK, Dhall SS, Berger MS, Manley GT, Tarapore PE. Adult sports-related traumatic brain injury in United States trauma centers. Neurosurg Focus 2017; 40:E4. [PMID: 27032921 DOI: 10.3171/2016.1.focus15613] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Sports-related traumatic brain injury (TBI) is an important public health concern estimated to affect 300,000 to 3.8 million people annually in the United States. Although injuries to professional athletes dominate the media, this group represents only a small proportion of the overall population. Here, the authors characterize the demographics of sports-related TBI in adults from a community-based trauma population and identify predictors of prolonged hospitalization and increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from adults (age ≥ 18 years) across 5 sporting categories-fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged hospital length of stay (LOS), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α < 0.05, and the Bonferroni correction for multiple comparisons was applied for each outcome analysis. RESULTS From 2003 to 2012, in total, 4788 adult sports-related TBIs were documented in the NTDB, which represented 18,310 incidents nationally. Equestrian sports were the greatest contributors to sports-related TBI (45.2%). Mild TBI represented nearly 86% of injuries overall. Mean (± SEM) LOSs in the hospital or intensive care unit (ICU) were 4.25 ± 0.09 days and 1.60 ± 0.06 days, respectively. The mortality rate was 3.0% across all patients, but was statistically higher in TBI from roller sports (4.1%) and aquatic sports (7.7%). Age, hypotension on admission to the emergency department (ED), and the severity of head and extracranial injuries were statistically significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Traumatic brain injury during aquatic sports was similarly associated with prolonged ICU and hospital LOSs, medical complications, and failure to be discharged to home. CONCLUSIONS Age, hypotension on ED admission, severity of head and extracranial injuries, and sports mechanism of injury are important prognostic variables in adult sports-related TBI. Increasing TBI awareness and helmet use-particularly in equestrian and roller sports-are critical elements for decreasing sports-related TBI events in adults.
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Affiliation(s)
- Ethan A Winkler
- Department of Neurological Surgery, University of California, San Francisco; and.,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, California
| | - John K Yue
- Department of Neurological Surgery, University of California, San Francisco; and.,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, California
| | - John F Burke
- Department of Neurological Surgery, University of California, San Francisco; and.,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, California
| | - Andrew K Chan
- Department of Neurological Surgery, University of California, San Francisco; and.,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, California
| | - Sanjay S Dhall
- Department of Neurological Surgery, University of California, San Francisco; and.,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, California
| | - Mitchel S Berger
- Department of Neurological Surgery, University of California, San Francisco; and
| | - Geoffrey T Manley
- Department of Neurological Surgery, University of California, San Francisco; and.,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, California
| | - Phiroz E Tarapore
- Department of Neurological Surgery, University of California, San Francisco; and.,Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, California
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20
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McKenzie LB, Fletcher E, Nelson NG, Roberts KJ, Klein EG. Epidemiology of skateboarding-related injuries sustained by children and adolescents 5-19 years of age and treated in US emergency departments: 1990 through 2008. Inj Epidemiol 2016; 3:10. [PMID: 27747547 PMCID: PMC4824795 DOI: 10.1186/s40621-016-0075-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 03/08/2016] [Indexed: 11/22/2022] Open
Abstract
Background The goal was to examine the patterns and trends of skateboarding-related injuries sustained by children and adolescents in the United States. Methods A retrospective analysis was conducted using data from the National Electronic Injury Surveillance System for children and adolescents 5-19 years of age treated in emergency departments for injuries associated with skateboards from 1990 through 2008. Results An estimated 1 226 868 children/adolescents (95 % CI: 948 733—1 505 003) were treated in emergency departments for skateboarding-related injuries from 1990 through 2008, an average of 64,572 cases per year. From 1990 through 1994, the annual rate of injuries per 10,000 children/adolescents significantly decreased overall and for males (overall: 72.9 %, P = 0.014; males: 73.9 %, P = 0.011; females: 63.6 %, P = 0.062). From 1994 to 2008, annual rates of injuries per 10,000 children/adolescents significantly increased overall and for both males and females (overall: 378.9 %, P < 0.001; males: 393.4 %, P < 0.001; females: 283.3 % P < 0.001). From 1990 to 1994 the annual rate of injuries per 10,000 children/adolescents significantly decreased for all age groups (5-10 years: 69.9 %, P = 0.043; 11-14 years: 80.6 %, P = 0.017; 15-19 years: 64.2 %, P = 0.024), and then significantly increased from 1994 to 2008 (5-10 years: 164.5 %, P < 0.001; 11-14 years: 587.0 %, P < 0.001; 15-19 years: 407.9 %, P < 0.001). Most patients were male (89.0 %), injured at home (37.3 %) or in the street and/or highway (29.3 %), and were not hospitalized (96.9 %). Patients 11-14 years of age constituted 44.9 % of cases. The most commonly injured body regions were the upper (44.1 %) and lower (31.7 %) extremities. Fractures and dislocations were the most common diagnoses (32.1 %). Children/adolescents 11-14 years of age were hospitalized more often than younger or older children/adolescents. Lower extremity injuries increased with age, while face and head or neck injuries decreased with age. Conclusions Skateboarding continues to be an important source of injury for children and adolescents. Further research, using more rigorous study designs, is required develop a broad perspective of the incidence and determinants of injury, and to further identify risk factors and viable injury countermeasures while simultaneously promoting participation in skateboarding.
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Affiliation(s)
- Lara B McKenzie
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, 43205, OH, USA. .,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA. .,Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA.
| | - Erica Fletcher
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, 43205, OH, USA
| | - Nicolas G Nelson
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, 43205, OH, USA
| | - Kristin J Roberts
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, 43205, OH, USA
| | - Elizabeth G Klein
- Division of Health Behavior & Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
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