title: Emergency department visits for head trauma in the United States.
abstract: BACKGROUND
  Head trauma affects millions of Americans each year and has significant morbidity and economic costs to society. The objective of this study is to describe the epidemiology of head traumas presenting to emergency departments in the United States.
  
  
  METHODS
  The National Electronic Injury Surveillance System-All Injury Program was queried to conduct a retrospective analysis of head traumas treated in U.S. emergency departments. 207,159 cases of nonfatal head trauma from January 1, 2007 to December 31, 2011 were included in this study.
  
  
  RESULTS
  An estimated 10,746,629 (95 % confidence interval: 8,368,720-13,124,537) head traumas were treated in U.S. emergency departments (EDs) during the study period, averaging 2,149,326 cases annually. The annual injury rate per 10,000 population increased from 55.2 in 2007 to 85.4 in 2011, with the largest increases seen in children ≤11 years of age and in adults >65 years of age. Traffic-related head trauma accounted for an estimated 1,819,824 visits to U.S. EDs over the study period and was associated with a 1.74 times greater risk of a hospital admission compared to injuries due to non-traffic-related causes. Assaults (95.9 %) were the most common reason for head trauma in cases where injury intent was documented, and 16.9 % of assault-related head trauma occurred in children 0-17 years of age. When analyzed separately from other head traumas, concussions increased by 37.5 % over the study period, and nearly a third (29.9 %) of all concussions were sports-related.
  
  
  CONCLUSIONS
  The increase in the number and rate of head traumas treated in U.S. EDs warrants continued injury prevention efforts and improvements in injury nomenclature and surveillance.
authors.affiliation: Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Building 421, Philadelphia, PA, 19104, USA. cgaw@mail.med.upenn.edu.
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Gaw
authors.affiliation: Department of Emergency Medicine, Alpert Medical School of Brown University, 55 Claverick St., 2nd floor, Providence, RI, 02903, USA. Zonfrillo@brown.edu.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Zonfrillo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D014481:United States / Q000453:epidemiology; D055815:Young Adult