Pediatric ice hockey injury trends presenting to US emergency departments: A 10-year review of national injury data

Introduction

Ice hockey is a high-contact sport that can often endanger athletes’ physical health, especially adolescents. Youth hockey players still learning to properly play the sport tend to be much more prone to serious injury. The goal of this study was to examine the frequency and trends of pediatric hockey-related injuries presenting to United States (US) emergency departments (EDs) amongst youth.

Methods

Ice hockey-related injuries presenting to US EDs from January 1st, 2014 to December 31st, 2023 were queried using the National Electronic Injury Surveillance System (NEISS). For each injury, patient disposition, demographics, diagnosis, and site of injury were recorded. National estimates (NEs) were calculated using the NEISS statistical sample weights. Injury trends were evaluated by linear regression modeling.

Results

There was a total of 3847 ED visits due to ice hockey-related injuries during the study period, resulting in an NE of 110,293 injuries. Linear regression analysis displayed no significant trend in annual injuries among females (p = 0.079) or males (p = 0.911). The frequency of injuries during 2014–2019 remained relatively steady, aside from a 46.0 % decrease from 2019 (n = 11,001) to 2020 (n = 5944), which returned to the original incidence level by 2022 (n = 12,963). A sudden increase in hospitalization rate post-pandemic was observed (p = 0.109), where the rate dramatically rose from 0.1 % to 5.6 %. Dislocations (8.5 %) had the highest rate of hospitalization amongst diagnoses. The most common injuries amongst all hockey players were injuries to the head (n = 37,816, 34.2 %) and shoulder (n = 16,836, 15.3 %). We observed a significant increase in head (p = 0.041) and shoulder (p = 0.020) injuries after 2020.

Conclusion

Although the overall number of injuries amongst youth hockey players did not change significantly over time, we saw a significant increase in head and shoulder injuries. Additionally, the hospitalization rate from these injuries has increased recently post-pandemic. The high and increasing frequency of head and shoulder injuries emphasizes the importance of proper protective equipment to these areas in pediatric athletes.