• Melissa C Kay, Johna K Register-Mihalik, Aaron D Gray, Aristarque Djoko, Thomas P Dompier, and Zachary Y Kerr.
• Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.
• J Athl Train. 2017 Feb 1; 52 (2): 117-128.

ContextFew researchers have described the incidence of the most severe injuries sustained by student-athletes at the collegiate level.ObjectiveTo describe the epidemiology of severe injuries within 25 National Collegiate Athletic Association (NCAA) sports in the 2009-2010 through 2014-2015 academic years.DesignDescriptive epidemiology study.SettingAggregate injury and exposure data from 25 NCAA sports.Patients Or Other ParticipantsCollegiate student-athletes in the 2009-2010 through 2014-2015 academic years.Main Outcome Measure(S)Injury data from the NCAA Injury Surveillance Program were analyzed. A severe injury (1) occurred during a sanctioned competition or practice, (2) required medical attention by an athletic trainer or physician, and (3) resulted in at least 21 days lost from sport activity or a premature end to the sport season. Injury counts, proportions, rates per 1000 athlete-exposures (AEs), rate ratios (RRs), and injury proportion ratios were reported with 95% confidence intervals (CIs).ResultsA total of 3183 severe injuries were reported, for an injury rate of 0.66/1000 AEs. Wrestling had the highest severe injury rate (1.73/1000 AEs), followed by women's gymnastics (1.40/1000 AEs) and football (0.97/1000 AEs). Overall, the severe injury rate was higher in competition than in practice (RR = 4.25, 95% CI = 3.97, 4.56). Most severe injuries were reported during the regular season (69.3%, n = 2206); however, severe injury rates did not differ between the preseason and regular season (RR = 0.98, 95% CI = 0.91, 1.06). Common severely injured body parts were the knee (32.9%, n = 1047), lower leg/ankle/foot (22.5%, n = 715), and head/face/neck (11.2%, n = 358). Common severe injury diagnoses were sprains (32.9%, n = 1048), strains (16.9%, n = 538), and fractures (14.4%, n = 458). Common severe injury mechanisms were player contact (39.3%, n = 1251), noncontact (25.1%, n = 800), and surface contact (12.0%, n = 383).ConclusionsSevere injuries occurred across many sports and by numerous mechanisms. By identifying these sport-specific patterns, clinicians' efforts can be tailored toward improving injury-prevention strategies and health outcomes.

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