The burden of hospitalized sports-related injuries in children: an Australian population-based study, 2005-2013

Abstract

Background: There is concern about recent increase and severity of sports-related injuries in children. Despite the benefits of sports participation, injuries may carry long-term health consequences. We aimed to evaluate the prevalence, characteristics and types of hospitalized sports-related injuries in children.

Methods: Population-based study of all acute sports-related injuries requiring hospitalization in children 5 to 15 years of age in New South Wales (NSW), Australia, 2005-2013. Health information was obtained from the NSW Admitted Patient Data Collection, a census of all hospital admissions from public and private hospitals. Children with a recorded ICD10-AM injury code (S00-T79) and sport-related activity code (U50-U70) were included. Prevalence and trend in injuries by age group, sporting code, body region affected and type of injury were assessed.

Results: There was a total of 20,034 hospitalizations for sports-related injuries (2.7% of all hospitalizations in children aged 5-15 years), involving 21,346 recorded injuries in 19,576 children. The overall population hospitalization period prevalence was 227 per 100,000 children aged 5-15 years in 2005-2013, remaining stable over time (RR 0.99; 95% CI 0.98-1.00). Football codes such as rugby league/union and soccer combined represented nearly two thirds of the total (60%). The most common body regions affected were the forearm (31%) head (15%) and hand injuries (13%). Fractures accounted for 65% of injuries followed by dislocations (10%) and traumatic brain injury (10%). Compared to other age groups, children aged 5-8 years had double the proportion of shoulder (15% vs. 7%) while 13-15 year olds had higher proportion of lower-leg (14% vs. 8%) and knee (6% vs.2%) injuries. One in seven injuries sustained while playing rugby league/union, baseball and hockey were traumatic brain injuries. A total of 444 (2.2%) of children had more than one hospitalization for sports-related injuries.

Conclusion: On average, six children were hospitalized every day for sports-related injuries in the last decade with trends remaining stable. The most common sports involved were football codes, one in three injuries involved the forearm and two thirds were fractures. These findings can be used to inform health policy and sporting governing bodies to target preventive interventions and promote safe sports participation in children.

Keywords: Children and adolescent sports; Epidemiology; Hospital admissions; Sports-related injuries; Traumatic brain injury.

Fig. 1

Trend of sports-related injuries hospitalizations by age groups in children in NSW, Australia, 2005–2013. Relative risk RR (95% CI) for trend in population prevalence: all RR 0.99 (0.98–1.00); 5 to 8 years RR 0.98 (0.96–1.00); 9 to 12 years RR 1.00 (0.98–1.00) and 13 to 15 years: RR 1.00 (0.99–1.01)

Fig. 2

Sports-related injuries hospitalizations by sex in children in NSW, Australia, 2005–2013

Fig. 3

Sports-related injury hospitalizations of severe injuries by sporting code in children in NSW, Australia, 2005–2013. Severe injuries represent those with length of stay of 3+ days, requiring major surgery, intensive care unit admission, mechanical ventilation or blood transfusion; Only sports with >100 total hospitalizations are reported

Fig. 4

Proportion of hospitalized sports-related injuries by sport and body region in children in NSW, Australia, 2005–2013. ^*Only sports with >100 total hospitalizations are reported; numbers represent percentages

Fig. 5

Proportion of hospitalized sports-related injuries by sport and type of injury in children in NSW, Australia, 2005–2013. ^*Only sports with >100 total hospitalizations are reported; numbers represent percentages