Epidemiology of acute head injuries in Canadian children and youth soccer players

Background: Limited studies have been done to assess head injury characteristics for children and youth soccer players in Canada. Objectives: To describe acute head injury characteristics in children and youth soccer players and identify the characteristics of patients who required hospital admission. Methods: Analysis was based on the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP). Soccer-related head injuries amongst 5-19 year old children presenting at 16 hospital emergency departments during 1994-2004 were selected in the study. All head injury-related variables (nature of injury, mechanism of injury, location of play, soccer type and season of play) were stratified by age and sex. A logistic regression model, consisting of the injury-related variables, sex and age as the independent variables, was performed to examine the characteristics of those head-injured patients who required hospital admission. Results: Overall, there were 4720 head injury cases identified (15% of all soccer-related emergency department visits). The highest proportion of head injuries was amongst males (70%) and children aged 10-14 years (50%). Of head injury cases, 35% were superficial and/or open wounds, 28% minor head injuries, 11% concussions, 9% eye injuries and 5% fractures. The total number of cases that required hospital admission was 164 (3.5%). Based on logistic regression analysis, head-injured youth aged 15-19 years were almost two times more likely to be admitted to hospital than their younger counterparts (OR = 2.2, 95% CI: 1.3-3.6). Compared to ball contact injuries, contact with structures/surfaces, other players/persons and other unspecified objects increased the odds of hospital admission at least by two-folds. Moreover, those who played unorganised soccer were significantly more likely to be admitted to the hospital as compared to those who played organised soccer (OR = 1.7, 95% CI: 1.2-2.6). Finally, playing in the non-winter seasons had increased likelihood of hospital admissions. Conclusions: Head injuries constituted a significant proportion of soccer-related injuries presenting to emergency departments. Future studies need to evaluate the nature and safety of the playing surfaces/turf and other structures on or around the field of play. (C) 2009 Elsevier Ltd. All rights reserved.