title: A substantial proportion of life-threatening injuries are sport-related.
abstract: OBJECTIVE
  This study aimed to assess the proportion of all life-threatening injuries that are sport-related.
  
  
  METHODS
  We conducted a cross-sectional study of patients included in the National Hospital Ambulatory Medical Care Survey during the years 1999 to 2008. Life-threatening injuries were defined according to the International Classification of Diseases, Ninth Revision codes: skull fracture (800.x-802.xx, 803.x-804.xx), cervical spine fractures (805.xx-806.10), intracranial hemorrhage (852.xx-853.xx), traumatic pneumothorax/hemothorax (860.00-860.05), liver lacerations (864.xx), spleen lacerations (865.xx), aortic rupture (901.0; 902.0), gastric/duodenal rupture (537.89), heat stroke (992.0), and commotio cordis/heart contusion (861.01). Sport-related was defined by the external cause of injury codes, confirmed by text search.
  
  
  RESULTS
  There were 300,394 observed emergency department visits during the study period. An estimated 0.5% (95% confidence interval [CI], 0.5%-0.6%) of all emergency department visits nationally were for life-threatening injuries. Of the life-threatening injuries, 14% (95% CI, 12%-17) were sport-related, representing 926,805 sport-related, life-threatening injuries nationally. A higher percentage (32%; 95% CI, 27%-38%) of life-threatening injuries sustained by children was sport-related when compared with adults (9%; 95% CI, 7%-11%). For adults aged 19 to 44 years, 12% (95% CI, 9%-15%) of life-threatening injuries were sport-related. For children aged 6 to 18 years, 39% (95% CI, 33%-46%) of life-threatening injuries were sport-related. Nearly a quarter (23%; 95% CI, 7%-55%) of pediatric cervical spine fractures was sport-related. The percentage of cervical spine fractures that were sport-related was lower for adults (7%; 95% CI, 4%-11%).
  
  
  CONCLUSIONS
  Efforts should be made to prevent the number of sport-related, life-threatening injuries.
authors.affiliation: The Micheli Center for Sports Injury Prevention, Waltham, MA, USA. william.meehan@childrens.harvard.edu
authors.forename: William P
authors.initials: WP
authors.lastname: Meehan
authors.forename: Rebekah
authors.initials: R
authors.lastname: Mannix
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000453:epidemiology*; D002574:Cervical Vertebrae / Q000293:injuries; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006335:Heart Injuries / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007223:Infant; D038801:International Classification of Diseases; D020300:Intracranial Hemorrhages / Q000453:epidemiology / Q000209:etiology; D008297:Male; D012189:Retrospective Studies; D012494:Sampling Studies; D012887:Skull Fractures / Q000453:epidemiology / Q000209:etiology; D016103:Spinal Fractures / Q000453:epidemiology / Q000209:etiology; D013898:Thoracic Injuries / Q000453:epidemiology / Q000209:etiology; D015599:Trauma Severity Indices; D055815:Young Adult