Catastrophic injuries in high school and college baseball players.

Background: There are few epidemiologic studies of catastrophic baseball injuries.

Purpose: To develop a profile of catastrophic injuries in baseball players and to describe relevant risk factors.

Study Design: Retrospective cohort study.

Methods: The authors reviewed 41 incidents of baseball injuries reported to the National Center for Catastrophic Sports Injury Research from 1982 until 2002.

Results: There were an estimated 1.95 direct catastrophic injuries per year, or 0.43 injuries per 100,000 participants. The most common mechanisms of injury were a collision of fielders (9) or of a base runner and a fielder (8), a pitcher hit by a batted ball (14), and an athlete hit by a thrown ball (4). Catastrophic injuries included 23 severe head injuries, 8 cervical injuries, 3 cases of commotio cordis, and 2 cases each of a collapsed trachea and facial fractures. Three athletes sustained a severe head injury and facial fractures. Ten of the 41 injuries were fatalities.

Conclusions: Suggestions for reducing catastrophic injuries in baseball include teaching proper techniques to avoid fielding and baserunning collisions, protecting the pitcher via a combination of screens and/or helmets with faceguards, continued surveillance and modifications of the bat and ball, eliminating headfirst slides, and continued analysis of chest protectors and automatic external defibrillators for commotio cordis.