Injuries sustained by rugby players presenting to United States emergency departments, 1978 through 2004

Abstract

Context: Although the United States has nearly 60 000 rugby players, to date no nationally representative rugby injury studies have been conducted.

Objective: To describe rugby players with injuries presenting to a representative sample of US emergency departments from 1978 through 2004.

Design: Retrospective study.

Setting: US Consumer Products Safety Commission's National Electronic Injury Surveillance System.

Patients or other participants: Rugby players presenting to emergency departments in participating hospitals from October 1, 1978, through December 31, 2004.

Main outcome measure(s): We reviewed all rugby players with injuries captured by the National Electronic Injury Surveillance System and categorized them by sex, age, injury site, and injury diagnosis.

Results: An estimated 236 539 rugby players presented to US emergency departments from 1978 through 2004. Injured athletes tended to be male (87.2%) and older than 18 years of age (86.0%). The face (20.5%), shoulder (14.1%), head (11.5%), and ankle (9.1%) were the most frequently injured sites. Strain/sprain (24.3%), laceration (22.1%), fracture (18.7%), and contusion/abrasion (16.6%) were the most common diagnoses. Males presented with more face injuries (injury proportion ratio [IPR] = 2.05, 95% confidence interval [CI] = 1.54-2.72, P < .001) and more lacerations (IPR = 4.23, 95% CI = 2.87-6.22, P < .001) and dislocations (IPR = 2.17, 95% CI 1.51-3.13, P < .001). Females presented with more knee injuries (IPR = 1.67, 95% CI = 1.36-2.06, P < .001) and more contusions/abrasions (IPR = 1.48, 95% CI = 1.14-1.92, P < .001) and strains/sprains (IPR = 1.39, 95% = CI 1.16-1.67, P < .001). Those 18 years of age or younger presented with more concussions (IPR = 1.62, 95% CI = 1.06-2.50, P < .001), while those over 18 presented with more lacerations (IPR = 1.83, 95% CI = 1.30-2.57, P < .001). In males, fractures were more common among those 18 years of age or younger (IPR = 1.47, 95% CI = 1.24-1.75, P < .001).

Conclusions: Rugby injury patterns in the United States differed by age and sex. Understanding such patterns should assist certified athletic trainers in developing targeted preventive interventions.

Figure 1. Estimated number of rugby players with injuries presenting to US emergency departments by year and age, 1980 through 2003. National estimates for those 18 years or younger for 1979 through 2001 are based on actual case counts below 50 and, thus, may be unstable. These numbers represent 3-year rolling averages calculated with statistical weights provided by the Consumer Product Safety Commission's National Electronic Injury Surveillance System. The rugby product code was introduced on October 1, 1978, making 1979 the first full year for rugby injury data collection and allowing 1980 to be the first 3-year rolling average

Figure 2. Sex differences in weighted case counts of rugby players with injuries presenting to US emergency departments by body site injured, 1978 through 2004. Percentages may not sum to 100% because of cases with other/unspecified injury sites. Estimates based on <50 cases may not be reliable and interpretation should be cautious. A, Male rugby players, n = 206 322. B, Female rugby players, n = 30 217

Figure 3. Age differences in weighted case counts of rugby players with injuries presenting to US emergency departments by body site injured, 1978 through 2004. Percentages may not sum to 100% because of cases with other/unspecified injury sites. Estimates based on <50 cases may not be reliable and interpretation should be cautious. A, Rugby players 18 years of age or younger, n = 33 123. B, Rugby players older than 18 years of age, n = 203 416

Figure 4. Sex and age differences in rugby players with injuries presenting to US emergency departments by injury diagnosis, 1978 through 2004. Estimates based on <50 cases may not be reliable, and interpretation should be cautious. A, All cases. B, Males. C, Females