Elbow Injuries Among MLB Pitchers Increased During Covid-19 Disrupted Season, But Not Other Baseball Injuries.

Background: The 2020 Major League Baseball Season (MLB) demonstrated season disruptions due to the COVID-19 pandemic. Changes in training and seasonal time frames may be associated with higher rates of injury. Purpose: To use publicly available data to compare injury rates during the 2015-2019 seasons, COVID-19 shortened season (2020), and the 2021 season stratified by body region and position (pitchers versus position players). Study Design: A retrospective cohort study utilizing publicly available data. Methods: MLB players who competed in 1+ seasons between 2015-2021 were included and stratified by position (pitcher, position player). Incidence rate (IR), reported by 1000 x Athlete-Game Exposures (AGEs), was calculated for each season, and stratified by position and body region. Poisson regressions were performed for all injuries and stratified by position to determine association between season and injury incidence. Subgroup analyses were performed on the elbow, groin/hip/thigh, shoulder. Results: Four thousand, two hundred and seventy-four injuries and 796,502 AGEs across 15,152 players were documented. Overall IR was similar across seasons (2015-2019:5.39; 2020:5.85; 2021:5.04 per 1000 AGEs). IR remained high for the groin/hip/thigh for position players (2015-2019:1.7; 2020:2.0; 2021:1.7 per 1000 AGEs). There was no difference in injury rates between 2015-2019 and 2020 seasons [1.1 (0.9-1.2), p=0.310]. The 2020 season demonstrated a significant increase in elbow injuries [2.7 (1.8-4.0), p<0.001]; when stratified by position, this increase remained significant for pitchers [pitchers: 3.5 (2.1-5.9), p<0.001; position players: 1.8 (0.9-3.6), p=0.073]. No other differences were observed. Conclusion: The groin/hip/thigh demonstrated the highest IR in 2020 among position players across all season time frames, indicating that continued injury mitigation for this region is necessary. When stratified by body region, elbow injury rates among pitchers demonstrated 3.5 times the rate of injury in 2020 compared to previous seasons, impacting injury burden for the most vulnerable body region among pitchers. Level of Evidence: Level III.

Pac-12 Health Analytics Program (HAP): An Innovative Approach to Health Care Operations, Data Analytics and Clinical Research in Intercollegiate Athletics.

OBJECTIVE: To describe the purpose, methods, and impact of the Pac-12 Health Analytics Program (HAP) approach on sports medicine informatics, research, analytics, and health care operations. BACKGROUND: Sports injury surveillance initiatives have been supporting the clinical research community in sports medicine for nearly four decades. Whereas initial systems tracked only a few sports, current surveillance programs have expanded to include entire professional and elite athlete organizations, providing important statistics on sports injury risk management. DESCRIPTION: The HAP is a conference-wide data sharing and analytics program. It includes authorized, de-identified clinical data, encompassing multiple domains of sports medicine injury management, including sports injury/illness, concussion, risk exposure, and COVID-19 testing elements. The HAP provides clinicians access to curated data to inform evidence-based practice and support local health care operations of emerging sports injury trends. The HAP provides approved research groups access to a data repository that describes a homogeneous, elite intercollegiate athlete sample that supports non-research clinical initiatives as well as contributes to peer-reviewed research that can improve the health and well-being of Pac-12 student-athletes. CONCLUSIONS: The HAP is a different approach to sports injury epidemiology and surveillance. The HAP has allowed the Pac-12 Conference to meet larger objectives around improving the student-athlete experience and clinical research among its member schools. Data quality control has improved the accuracy of data and value to clinical athletic trainers within the conference. Curated dashboards displaying aggregated project data provide clinicians with data-driven decision-making tools that help inform sports injury risk management. As of 2021, the HAP has supported over three dozen research requests that have resulted in numerous peer-reviewed research contributions to the sports medicine community whose findings have great potential to improve the health and well-being of Pac-12 student athletes.

Effect of COVID-19 lockdown on injury incidence and burden in amateur rugby union.

OBJECTIVES: To analyse match and training injury incidence rates and burden from pre-(2019) and post-COVID-19 (2021) seasons; To analyse injury related variables as mechanisms, type, body locations, severity and the differences of the most common injuries according to playing positions. DESIGN: An observational study was performed according to the consensus statement on injury definitions and data collection from World Rugby. Injury variables were collected retrospectively for 2019 season and prospectively during 2021 season. SETTING: Argentinian amateur rugby club. PARTICIPANTS: Male (n = 110) senior amateur rugby players. MAIN OUTCOME MEASURES: Match and training time loss injuries, time of exposures and injury related variables. RESULTS: Training incidence rate during post-lockdown season (4.2/1000 player-training-hours) was significantly higher (p < 0.001) than the pre-lockdown season (0.9/1000 player match hours). Post-lockdown hamstring strain injury (HSI) and concussions match incidence rates were significantly (p < 0.001; p < 0.05 respectively) higher in comparison with 2019 season. Regarding playing positions, backs showed a significantly increase (p < 0.05) in HSI match incidence rate post lockdown. CONCLUSIONS: After the COVID-19 lockdown, training incidence rate was significantly higher than previous season (2019), showing the impact of the lockdown restrictions. Coaches and medical staff must consider that players probably need more lead-in time for conditioning and more monitoring after periods of no rugby.

Improving injury surveillance data quality: a study based on hospitals contributing to the Victorian Emergency Minimum Dataset.

OBJECTIVE: In this paper, we describe the design and baseline data of a study aimed at improving injury surveillance data quality of hospitals contributing to the Victorian Emergency Minimum Dataset (VEMD). METHODS: The sequential study phases include a baseline analysis of data quality, direct engagement and communication with each of the emergency department (ED) hospital sites, collection of survey and interview data and ongoing monitoring. RESULTS: In 2019/20, there were 371,683 injury-related ED presentations recorded in the VEMD. Percentage unspecified, the indicator of (poor) data quality, was lowest for 'body region' (2.7%) and 'injury type' (7.4%), and highest for 'activity when injured' (29.4%). In the latter, contributing hospitals ranged from 3.0-99.9% unspecified. The 'description of event' variable had a mean word count of 10; 16/38 hospitals had a narrative word count of <5. CONCLUSIONS: Baseline hospital injury surveillance data vary vastly in data quality, leaving much room for improvement and justifying intervention as described. IMPLICATIONS FOR PUBLIC HEALTH: Hospital engagement and feedback described in this study is expected to have a marked effect on data quality from 2021 onwards. This will ensure that Victorian injury surveillance data can fulfil their purpose to accurately inform injury prevention policy and practice.

Pandemic Puppies: Man's Best Friend or Public Health Problem? A Multidatabase Study.

INTRODUCTION: The public health implications of the COVID-19 pandemic reach beyond those of the disease itself. Various centers have anecdotally reported increases in the incidence of dog bite injuries which predominate in pediatric populations. The reasons for this increase are likely multifactorial and include an increase in canine adoptions, remote learning, and psychosocial stressors induced by lockdowns. We hypothesized that there was a significant increase in the proportion of dog bite injuries at our institution and within a nationally representative cohort. METHODS: We queried our electronic health record and the National Electronic Injury Surveillance System (NEISS) for all records pertaining to dog bites between 2015 and 2020, and the annual incidence was calculated. Poisson regression was then used to estimate whether there was a significant difference in the adjusted risk ratio for each year. RESULTS: The institutional and national cohorts revealed relative increases in the incidence of dog bite injury of 243 and 147.9 per 100,000 over the study period, respectively. Both cohorts observed significant increases of 44% and 25% in the annual incidence relative to 2019, respectively. Poisson regression revealed a significantly elevated adjusted relative risk in the institutional cohort for 2020 (2.664, CI: 2.076-3.419, P < 0.001). The national cohort also revealed an increase (1.129, CI: 1.091-1.169, P < 0.001). CONCLUSIONS: A nationwide increase in the incidence of dog bite injuries among children was observed during COVID-19 in 2020. These findings suggest that dog bites remain a public health problem that must be addressed by public health agencies.

The National Interscholastic Cycling Association (NICA) Mountain Biking Injury Surveillance System (ISS): Analysis of 66,588 Student Athlete-Years of Injury Data.

Interscholastic youth cross-country mountain bike racing in the United States has grown significantly over the past decade, yet little is known about the risk profile in this age group. Aiming to protect participants, we implemented a prospective, longitudinal injury surveillance system for the purpose of better understanding youth mountain biking injuries and implementing safety measures. Data were collected during competition years 2018-2020, totaling 66,588 student athlete-years. Designated reporters from each team received weekly emails with exposure and incident report forms. Variables analyzed included demographic, rider-related, trail-related, and other data. Injury characteristics during the COVID-19 pandemic in 2020 were compared to the years 2018 and 2019. More student athletes participated in the 2020 season (25,261) than in prior seasons (18,575 in 2018 and 22,752 in 2019). During competition year 2020, overall injury proportion was lower (1.7% versus 3.0% in 2018 and 2.7% in 2019). Variables associated with injury, body part injured, type of injury, time-loss, and disposition following injury were similar between all years. Despite the pandemic and resultant changes to competition, student athletes continued to ride their bikes and become injured, but the proportion of injuries differed. This report details injury characteristics in youth mountain bike racing, including a comparison of before and during the pandemic.

Comparing pattern of musculoskeletal injuries prior to and during COVID-19 lockdown: A time-trend case study from a tertiary level Trauma Center of Northern India.

BACKGROUND AND AIMS: In the COVID-19 times, Indian sub-continent is struggling to contain the epidemic and trying to strengthen the existing health infrastructure, the national level lockdown has raised concerns about the pattern of injuries whether it has remained the same or has changed over this period. This is the first study to compare injury pattern during the two months lockdown period with the data of corresponding months from years 2016-2020. Also we compared the age- and sex-wise distribution patterns of these injuries for the above mentioned period. METHODS: This retrospective cross sectional study was conducted by the Department of Orthopaedics in Guru Gobind Singh Medical College and Hospital (GGSMCH) in Faridkot, Punjab. Secondary data for patient's age and sex, mode of injury, and site of injury was collected through record review for the period of two months (24th March to 24th May) for five consecutive years of 2016-2020. Descriptive analysis and Chi-square test was used to see the association between age and sex with mode and type of injury. RESULTS: The five year injury trends reflected that the proportion of injuries in 2016 was 16.5% (n = 48) of the total musculoskeletal injuries (n = 291) which rose to 23.4% (n = 68) in 2020. Majority of the patients were males (80%), and belonged to adult age group (69.4%) followed by elderly (17.2%), adolescents (8.6%) and children (4.8%). The proportion of road traffic accidents out of all injuries significantly reduced during the lock down period of two months in 2020 (p = 0.001). On the contrary, the proportion of injuries due to falls as well as unspecified assault increased significantly in 2020 as compared to previous years. CONCLUSIONS: The proportion of musculoskeletal injuries have increased from 2016-2020. Unspecified assault and all types of falls pushed the road traffic accidents to third position during the lockdown period in 2020 as compared to previous four years. Injury surveillance needs to be integrated in routine hospital system for precise information and for more efficient functioning.