Catastrophic Severe Injuries In Softball An 8-year Epidemiologic Study

Catastrophic injuries occur in softball and can result in severe injury. Literature is sparse describing severe injuries among softball players. Further knowledge is needed to describe severe softball injuries to inform response, treatment, and prevention efforts. PURPOSE: Describe the incidence, characteristics, and mechanisms of severe softball injuries between 2014 to 2021. METHODS: Two national surveillance systems were used: National Center for Catastrophic Sport Injury Research (NCCSIR) and National Electronic Injury Surveillance System (NEISS). NCCSIR included catastrophic injuries during participation in high school (HS) or college sponsored softball resulting in death, temporary or permanent disability, or life-threatening injury with recovery. NEISS included severe injuries (softball product code 5034) among 13-17 and 18-24 year olds with the following dispositions: hospital admission, treated and transferred, or fatal. National estimates were derived using a weighted sample for NEISS. Descriptive statistics included counts (%) and incidence rates (IR) per 100,000 participants overall and by sport level or age group. RESULTS: NCCSIR captured 8 injuries, with an overall incidence of 0.3 injuries per 100,000 participants (95% confidence interval (CI): 0.1-0.5). Incidence was higher in college (IR = 2.5, 0.9-6.6) compared to HS (IR = 0.1, 0.1-0.4). All athletes were female (8, 100%), most were baserunners (3, 38%). Sudden cardiac arrest was the most common injury event (5, 63%). 2 (25%) fatalities were reported. NEISS captured 35 severe injuries (1167 nationally), with an overall incidence of 10.2 injuries per 100,000 participants (9.7,10.8). Incidence was higher in 18-24 year olds (IR = 8.9, 8.3-9.6) compared to 13-17 year olds (IR = 4.2, 3.8-4.6). 66% (770) were female and 77% (899) of injuries occurred to the head/face. No fatalities were captured in the NEISS surveillance system. CONCLUSION: College-aged athletes were more susceptible to severe catastrophic injuries compared to high school-aged athletes. NCCSIR observed a large proportion of cardiac events, whereas NEISS observed a larger proportion of head/face injuries. Further stakeholder engagement is needed to encourage reporting to discern injury and sport characteristics for response and prevention programs. National Center for Catastrophic Sport Injury Research Center provides internal funding for the project, lead author (CLM)