title: Epidemiology and Severity of Sports and Recreation Injuries Presenting to a Tertiary Adult Emergency Department.
abstract: OBJECTIVE
  This study aims to evaluate all sports and recreation injuries that present to an emergency department, identify the activity and injury patterns associated with hospital admission, and determine injuries that could be better treated in alternative care settings.
  
  
  METHODS
  This is a retrospective review of all sports injuries that presented to the emergency department of a high volume, urban, tertiary referral center from 1/1/2010 to 12/31/2011. These were identified by a sports term search algorithm applied to all emergency department records. The main outcome measured was hospital admission status after sports injury. Univariate and multivariate regression analysis was performed to identify risk factors for hospital admission in the sports injury population.
  
  
  RESULTS
  1,101 of the 191,259 encounters (0.6%) had 1,210 sports injuries. 84 were admitted (7.6%). Basketball injuries were most prevalent (31.6%). All-terrain vehicle (ATV) related injuries was most often admitted (46.4%). Logistic regression identified ATV riding (95% CI 6.15-23.37, p < 0.001) and age over 50 years-old (4.09-17.40, p < 0.001) as independent risk factors for admission while basketball (0.101-0.985, p = 0.047) and black race (0.17-0.77, p = 0.008) were independently protective. Isolated sprains/strains and soft tissue injuries (4/649, 0.6%) rarely required admission.
  
  
  CONCLUSIONS
  The 7.6% admission rate is higher than previously reported, likely because the study institution is a tertiary referral center. ATV riding is associated with higher severity injuries that are more likely to require hospital admission. Most sports injuries that present to an emergency department, specifically isolated soft tissue injuries of the extremities, may be more efficiently treated in a non-emergent setting.
authors.affiliation: a Department of Orthopaedic Surgery , Washington University School of Medicine in Saint Louis , St. Louis , MO , USA.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Padegimas
authors.affiliation: a Department of Orthopaedic Surgery , Washington University School of Medicine in Saint Louis , St. Louis , MO , USA.
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Stepan
authors.affiliation: a Department of Orthopaedic Surgery , Washington University School of Medicine in Saint Louis , St. Louis , MO , USA.
authors.forename: Geoffrey E
authors.initials: GE
authors.lastname: Stoker
authors.affiliation: b Department of Emergency Medicine , Washington University School of Medicine in Saint Louis/Barnes-Jewish Hospital , St. Louis , MO , USA.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Polites
authors.affiliation: c Department of Orthopaedic Surgery , Washington University School of Medicine in Saint Louis/Barnes-Jewish Hospital , St. Louis , MO , USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Brophy
mesh_terms: D000328:Adult; D000367:Age Factors; D001265:Athletic Injuries / Q000453:epidemiology*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D015541:Off-Road Motor Vehicles; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D019037:Urban Health Services
keywords: ATV injuries; Sports injuries; concussion; emergency department; hospital admissions