RESULTS
From 2009-2018, two hundred and thirty-five (n=235) volleyball-related facial trauma ED visits were recorded in the NEISS database with an estimated 10,424 (95% CI: 6,158-14,690) visits occurring nationally. ED visits tended to decrease annually across the ten-year period, with 488 being the lowest reported visits in 2013 [Figure 1].
The majority of injuries were amongst young adults 20-29 years of age, encompassing 52.3% of the sample. Conversely, older adults aged ≥ 60 years comprised the lowest (6%) volume of ED visits. The demographic makeup of the study population was evenly male and female (49.4% and 50.6%, respectively). Caucasian patients were the majority of participants (51.9%), however, race was not reported in 30.6% of patients. Among injury types, lacerations were the most frequent (37.9%), with contusions/abrasions and concussions also being common (26.4% and 25.1%, respectively). The face was the most common site of injury (41.7%), followed by the head (35.7%). “Other” injury locations (neck and ear injuries) were the least frequent (3.8%). The majority (97.6%) of patients evaluated in the ED and subsequently released [Table 1].
Injury type appeared to be related to injury location. In regards to lacerations, the face was the most commonly affected site (67.4%). Lacerations were significantly less likely to involve the globe (2.2%) and mouth (16.9%). Contusions/abrasions commonly involved the globe (35.5%), face (32.3%), and head (27.4%). The vast majority of fractures involved the face (85.7%) [Table 2]. Further stratifying of fractures by location was performed, however statistical analysis was not conducted due to the small sample size (n=21). The majority of fractures involved the nose (71.4%) and were amongst individuals aged 20 through 49 (90.5%). Fractures involving the midface (9.5%), cervical spine (9.5%), mandible (4.8%), and skull (4.8%) were far less common [Figure 2].
Although age did not significantly influence injury type or location [data not shown], these patterns were affected by sex. Males had significantly more lacerations than females (75.3% vs. 24.7%), whereas females had significantly more contusions/abrasions (64.5% vs. 35.5%) and concussions (72.9% vs. 27.1%) [Table 3]. Males were more likely to sustain injuries to the face (60.2% vs. 39.8%), while females were more likely to sustain injuries to the head (67.9% vs. 32.1%). This was largely driven by the higher frequency of concussions in females [Table 4].