The Growing Burden of Neurological Injuries in Youth Tackle Football: A Nationwide Analysis (2016–2020)

Introduction: Recent interest in the study of neurological injuries, particularly concussions, has highlighted the public health implications of tackle football in the U.S. youth population. This study aims to examine the burden of neurological injuries sustained from tackle football in pediatric and adolescent populations using data from the National Emergency Department Sample (NEDS) and National Inpatient Sample (NIS) between 2016 and 2020.

Methods: We performed a retrospective analysis of NEDS and NIS databases, focusing on patients aged 0-20 years who presented to emergency departments (EDs) or were admitted for injuries related to tackle football. Neurological injuries included concussions, skull fractures, intracranial injuries, and spinal cord injuries (SCI). Patient demographics, length of stay (LOS), total hospital charges, and the types of hospitals (teaching, trauma centers) were analyzed using logistic regression models.

Results: A total of 870,000 patients presented with football-related injuries over the study period. Of these, 1.15% required inpatient admission (mean LOS: 2.5 days). 81.5% of ED visits involved patients under 18 years, with the incidence of concussions showing a 14% increase from 2016 to 2020 (P < 0.01). The most common neurological injuries were concussions (82%), with 1,976 spinal injuries identified. Spinal cord injuries had the highest likelihood of requiring inpatient admission (42.5% of SCI cases). Combined ED and inpatient charges totaled $1.6 billion during the period, with a significant portion of cases admitted to trauma centers and teaching hospitals. Ten fatalities were recorded, primarily in cases involving severe intracranial trauma.

Conclusion : Tackle football-related injuries, especially concussions, remain a significant cause of ED visits and hospital admissions in the pediatric population. The increasing incidence of concussions highlights the need for continued prevention efforts and safety regulations. The findings underscore the importance of long-term studies to assess the cumulative impact of repetitive head injuries in youth football.