More Kids' ER Visits Doesn't Mean Worse Injuries

Traumatic brain injuries in kids from sports not leading to increased hospital admissions

(RxWiki News) The issue of brain injury in children from playing sports has gained attention over the past several years. But that doesn't mean the injuries themselves have gotten worse.

A recent study found that the number of children admitted to the hospital after an emergency room visit for a head injury hasn't changed over a decade.

The severity of injuries seen in the emergency room has actually decreased during the time studied.

Even though more children are going to the ER with traumatic brain injuries, it appears that the injuries themselves are milder than seen in the past.

"Seek medical care after a child experiences a head injury."

The study, led by Holly Hanson, MD, of the Division of Emergency Medicine at Cincinnati Children's Hospital Medical Center, looked at increases in emergency room visits for sports-related traumatic brain injuries.

Past research has already shown that these ER visits have been increasing, so the researchers specifically wanted to learn more about the severity of the cases and the number of admissions that occurred.

The researchers focused on patients aged under 1 to age 19 who had gone to a particular level 1 trauma center between 2002 and 2011.

The researchers used hospital medical records to identify all the patients who had a primary or secondary diagnosis of traumatic brain injury.

During that time period, sport activities were responsible for 15.4 percent of the total traumatic brain injury cases in children and teens, which was 3,878 cases.

The sports included football, basketball, soccer, baseball/softball, skateboarding/roller blading, skiing, swimming, sledding and hockey — plus a category for all other sports including gymnastics and volleyball.

Injuries involving bicycling, playground activities or near-drownings unrelated to swimming sports were not included.

"Common, competitive sports such as soccer, basketball, and football had the highest numbers of sports-related TBI in the emergency department," the researchers wrote. "Skiing, sledding, and roller blading or skateboarding were shown to be responsible for the greatest ratio of [hospital] admissions for sports-related traumatic brain injuries."

Of the sports-related traumatic brain injury cases, 90 percent were discharged from the hospital and 10 percent were admitted to the hospital.

Among these patients, 73 percent were male and 78 percent were white, with an average age of 13.

The researchers found that traumatic brain injuries resulting from sports increased 92 percent during the years from 2002 to 2011.

However, the percentage of children admitted to the hospital from the ER during those years did not increase.

In fact, there was a slight decrease in how long the patients who were admitted stayed at the hospital, and the average severity of the injuries, based on a scoring system used at the hospital, decreased over that time.

"In our study, the proportion of children admitted from the emergency department for a sports-related traumatic brain injury remained on average 9.6 percent across all 10 years," the researchers wrote.

"Despite no change in the proportion of hospital admissions, the injury severity score significantly decreased, suggesting that more patients were being admitted with less severe injuries," the researchers wrote.

The study was published September 30 in the journal Pediatrics. The research was funded internally. The authors declared no conflicts of interest.

Review Date: 
September 29, 2013