The Most Dangerous Game: A Review of Head and Neck Injuries in American Football and Rugby

Study Design: The investigators designed and implemented a 20-year cross-sectional study using the National Electronic Injury Surveillance System database. Objective: The purpose of this study is to estimate and compare hospital admission (danger) rates between rugby and football of those who presented to the emergency department with head and neck injuries after playing these sports. Methods: The primary predictor variable was sport played. The primary outcome variable was danger, measured by hospital admission rates. Results: Over the past 20 years, there has been a trend of decreasing incidence of injuries presenting to the emergency department in both sports. There was no difference in the rate of hospital admission when comparing football and rugby (OR, 1.2; P = .1). Male gender was associated with an increased risk of admission. Other variables associated with hospital admission included white racial group, injury taking place in the fall, being either young (15-24 years old) or senior (65 years of age and over), and being injured at school or at a sport/recreational facility. Conclusions: There is no difference in danger as measured by admission rates between American football and rugby. There exists, however, several variables that are associated with admission when sustaining injury to the head and neck, when playing these two sports.