Epidemiological analysis of pediatric baseball and softball concussions in United States emergency departments.

PURPOSE: To evaluate the epidemiology of concussions in pediatric baseball and softball players. We hypothesized that head-to-ball injuries would be the most common cause of concussions.

METHODS: The National Electronic Injury Surveillance System (NEISS) database was used to gather data. Concussions occurring during baseball and softball participation in pediatric patients (4-17 years old) from 2012 to 2021 was gathered. Concussion mechanisms were grouped into 5 categories: head-to-player, head-to-ball, head-to-surface (ground, walls, railings), head-to-bat, and unknown. Linear regression models were used to assess changes in yearly concussion rates over the study period. Results from these models were reported using parameter estimates and the estimated Pearson correlation coefficient.

RESULTS: A weighted total of 54,978 baseball and softball related concussion injuries were analyzed. The average weighted age of our cohort at the time of injury was 13.1 years, with 54.1% (n = 29,761) of concussions occurring in males. The national estimated incidence of concussion injuries decreased non-significantly over the study period (slope estimate = -311 concussions/year, r = -0.625, p-value = 0.054). The majority of weighted national estimate concussions were due to head-to-ball injuries (n = 34,650; 63.0%), followed by head-to-player (n = 8501; 15.5%), head-to-surface (n = 5347; 9.7%), and head-to-bat (n = 5089; 9.3%). On sub-analysis, individuals were grouped into 3 age brackets: 4-8, 9-13, and 14-17 years. The most common mechanism of concussions in children of all ages was head-to-ball. The incidence of head-to-player and head-to-surface injuries increased throughout each age group, while head-to-bat decreased.

CONCLUSION: The incidence of concussions in pediatric baseball and softball athletes has been decreasing non-significantly over our 10-year study period. The most common mechanism of concussions in our study was head-to-ball injuries.