Pediatric hospitalizations related to sports participation: a 10-year comparative analysis across 18 commonly played sports in the United States

Pediatric sports injuries are common, yet there is limited information on the comparative risk of hospitalization across commonly played sports in the United States. We sought to identify youth sports associated with the highest incidence of hospital admission. Additionally, we sought to analyze temporal trends over the past decade and identify risk factors for admission.
The National Electronic Injury Surveillance System was queried for injuries during 18 sports in patients ages 3–18 from 2014 to 2023. Injury patterns and admission rates were calculated from national estimates. Temporal change in admission rate was assessed using linear regression. Logistic regression models were used to assess age, sex, race, day of week, and sport type as risk factors for hospitalization.
An estimated 186,695 admissions occurred during the study period, with an overall admission rate of 1.9%. The sports with the highest number of admissions per year were football (5,857, 31.4% of all admissions), basketball (3,563, 19.1%), and soccer (2,541, 13.6%). Gymnastics had the highest admission rate (3.2%), with 70% of admissions due to upper extremity fractures. Risk factors for hospitalization included male sex (OR 1.64, p < 0.001) and weekend participation (OR 1.10, p < 0.001). Hospitalization rate increased 0.08% per year (p = 0.001).
Football, basketball, and soccer contribute the majority of sports-related hospitalizations, consistent with known rates of participation and injury risk. Gymnastics has the highest admission rate among those presenting to the emergency department, commonly from upper extremity fractures. Males and those injured on the weekend are at increased risk for hospitalization. These findings should inform preventative efforts to reduce the risk of significant injury leading to hospitalization in young athletes.