(97) Basketball-Related Craniomaxillofacial Injuries: A NEISS Database Study

Abstract:

Background: Basketball is the second most popular sport worldwide, with a global fanbase exceeding 3.3 billion. However, participation carries a notable potential for injury, particularly within the craniomaxillofacial region, which includes the head, neck, and oral cavity. Due to its high-impact nature, athletes are susceptible to traumatic injuries, such as facial fractures, lacerations, and concussions.

Purpose: This study aims to identify the demographic and injury characteristics among basketball players with craniomaxillofacial injuries that are associated with an increased likelihood of hospitalization.
Study Design, Setting, and Sample: This is a retrospective cohort study that utilizes the National Electronic Injury Surveillance System (NEISS). Subjects included in this study presented to the emergency department (ED) and had sustained a craniomaxillofacial injury while playing basketball between January 1, 2014, and December 31, 2023.
Predictor Variable:The predictor variables analyzed in this study encompassed demographic factors (age, sex, race) and injury-related characteristics, including the specific craniomaxillofacial region affected and the type of diagnosis.
Main Outcome Variable: The primary outcome variable was injury severity, determined by whether the injury resulted in hospitalization or discharge (yes/no).
Covariates: The covariates in this study were a diverse set of variables that may influence the primary outcome.
Analyses: Descriptive statistics, contingency analyses, and bivariate logistic regression models were computed using GraphPad Prism 10.4.1. The Fisher’s exact test or Chi-squared test were used to generate two-sided P values from contingency table analyses of categorical variables. The odds ratio (OR), 95% confidence interval (CI) of OR, and two-sided P values for the logistic regression models were obtained using the Hosmer-Lemeshow goodness-of-fit test. P values < .05 were considered to have statistical significance.

Results: A total of 25,606 de-identified cases were analyzed (national estimate, 796,862). Age was a significant predictor of hospitalization, with individuals aged ≥40 years having 3.36 times higher odds (95% CI: 2.33–4.71, P < .0001), while those aged 10–19 had significantly lower odds (OR = 0.68, 95% CI: 0.55–0.85, P = .0005). Males were at increased odds of hospitalization compared to females (OR = 1.41, 95% CI: 1.06–1.91, P = .02).
The craniomaxillofacial region affected was strongly associated with hospitalization as well. Head injuries had the highest odds (OR = 2.25, 95% CI: 1.80–2.82, P < .0001), while injuries to the face (OR = 0.52, P < .0001) and mouth (OR = 0.12, P < .0001) were protective against hospitalization. Neck injuries increased the odds of hospitalization (OR = 1.86, 95% CI: 1.17–2.80, P = .01).
Diagnosis was also a strong predictor. Fractures carried the highest odds of hospitalization (OR = 5.29, 95% CI: 4.10–6.76, P < .0001), followed by internal organ injuries (OR = 1.99, P < .0001). In contrast, lacerations (OR = 0.13, P < .0001) and contusions/abrasions (OR = 0.09, P < .0001) were associated with lower odds of hospitalization.
Conclusion and Relevance: Hospitalization following basketball-related craniomaxillofacial injuries varies significantly by age, sex, injury location, and diagnosis. Older individuals, males and those with head injuries or fractures are more likely to be hospitalized, while facial soft-tissue injuries, lacerations, and contusions are less likely to require hospitalization. These findings are highly relevant to oral and maxillofacial surgeons, emergency physicians, and sports medicine specialists as they assist in prioritizing patient care. This can guide imaging decisions and interventions for higher-priority cases and inform preventive strategies, such as improved facial protective gear. Identifying factors associated with hospitalization can enhance resource allocation, reduce unnecessary admissions and improve patient outcomes.