Lu Victor M, Ramchandran Subaraman, Errico Thomas, George Stephen
Department of Neurological Surgery, University of Miami, Miami, FL 33136, USA.
Department of Orthopedic Surgery, Center for Spinal Disorders, Nicklaus Children's Hospital, Miami, FL 33155, USA.
J Clin Med. 2024 Dec 18;13(24):7713. doi: 10.3390/jcm13247713.
Although neck injuries secondary to sporting activities in the pediatric demographic presenting to the emergency department (ED) are common, predictors of needing higher-level care (HLC) outside immediate treatment and release are not clear. The aim of this study was to describe how these neck injuries present in the United States (US) and identify predictors of HLC. We interrogated the US National Electronic Injury Surveillance System (NEISS) database for presentations to the ED of pediatric patients (aged 6-18 years old) whose primary complaint was neck injury in the setting of sport between 2014 and 2023. Statistical analysis utilized weighted estimates to evaluate incidence and then univariate and multivariate regression analyses were carried out to identify parameters associated with HLC for these patients. Overall, a national weighted total of 360,885 ED presentations were estimated to have occurred in the last decade without any statistical change over the years. The mean age was 12.7 years, with more males (60.0%) than females (40.0%). The most common race observed was Black (50.6%), and these injuries most commonly occurred at a sporting complex (62.9%). Neck strains (59.9%) were the most common diagnosis seen across all presentations, followed by neck pain (29.1%), neck contusions (including abrasion) (6.4%), neck fractures (1.7%) and neck lacerations (0.8%). Ultimately, the majority of presentations were treated and released from the ED (95.5%). There were 4.5% of presentations, however, that did require HLC. Older age (OR 1.07, = 0.004), male gender (OR 1.51, = 0.002), involvement of other body part(s) (OR 1.45, = 0.007) and non-strain neck injuries (OR 11.8, < 0.001) were all independent, statistically significant predictors of HLC. Football (18.6%) was the most common sport associated with these presentations overall, but this was driven mostly by male cases. For females, the most common sport associated with these presentations was cheerleading (12.3%). In the last decade, neck injuries secondary to sporting activities in the pediatric demographic presenting to the ED have remained consistent. We have identified a unique set of predictors for presentations requiring HLC. These findings can be used in tandem with the findings that there are a number of gender-specific sports that drive these presentations to develop more sensitive and specific protocols for both primary prevention and ED triaging.
虽然因体育活动导致颈部受伤的儿科患者前往急诊科（ED）就诊的情况很常见，但除了立即治疗和出院外，需要更高水平护理（HLC）的预测因素尚不清楚。本研究的目的是描述这些颈部损伤在美国的表现，并确定HLC的预测因素。我们查询了美国国家电子伤害监测系统（NEISS）数据库，以获取2014年至2023年间主要因运动时颈部受伤而前往急诊科就诊的儿科患者（6至18岁）的情况。统计分析采用加权估计来评估发病率，然后进行单变量和多变量回归分析，以确定与这些患者HLC相关的参数。总体而言，估计在过去十年中全国加权总计有360,885例患者前往急诊科就诊，多年来没有任何统计学变化。平均年龄为12.7岁，男性（60.0%）多于女性（40.0%）。观察到的最常见种族是黑人（50.6%），这些损伤最常发生在体育场馆（62.9%）。颈部拉伤（59.9%）是所有就诊病例中最常见的诊断，其次是颈部疼痛（29.1%）、颈部挫伤（包括擦伤）（6.4%）、颈部骨折（1.7%）和颈部撕裂伤（0.8%）。最终，大多数就诊患者在急诊科接受治疗后出院（95.5%）。然而，有4.5%的就诊患者确实需要HLC。年龄较大（OR 1.07，P = 0.004）、男性（OR 1.51，P = 0.002）、涉及其他身体部位（OR 1.45，P = 0.007）和非拉伤性颈部损伤（OR 11.8，P < 0.001）都是HLC的独立且具有统计学意义的预测因素。足球（18.6%）是总体上与这些就诊病例相关的最常见运动，但这主要是由男性病例驱动的。对于女性来说，与这些就诊病例相关的最常见运动是啦啦队（12.3%）。在过去十年中，因体育活动导致颈部受伤的儿科患者前往急诊科就诊的情况保持稳定。我们已经确定了一组独特的需要HLC就诊病例的预测因素。这些发现可与以下发现一起使用，即有许多特定性别的运动导致了这些就诊情况，从而制定更敏感和具体的一级预防和急诊科分诊方案。
