Acknowledgements

This report is authored by Colleen Drul, Injury Data Analyst, at the Injury Preven on Centre.
The Injury Preven on Centre would like to acknowledge and thank the following people and organiza ons who contributed to the development of this report:
Karen Israelson
Alberta Health Services
Senior Analyst-Repor ng Services
Analy cs (DIMR)
Allison Marrio
Hockey Alberta
Coordinator, Opera ons

TheInjuryPreven onCentre
Injury Preven on Centre (IPC) leads the reduc on of catastrophic injuries and deaths in Alberta. The Centre is a catalyst for ac on by suppor ng communi es and decision-makers with knowledge and tools. The Injury Preven on Centre collaborates with stakeholders from mul ple sectors, draws knowledge from a variety of sources, uses data to set
priori es, acknowledges the importance of balancing research with context, and recognizes the complexity of factors
that contribute to injury the provide resources for ac on.
The Injury Preven on Centre is part of School of Public Health at the University of Alberta and funded in part by the
Government of Alberta.

ReportObjec ve
The objec ve of this report is to provide an overview of hockey-related injuries of children and youth in minor hockey
between the ages of 5 and 17 years who visited an emergency departments in Alberta. The primary data are the number of hockey-related injury emergency department visits and age specific rates per 10,000 registrants.

DataSources
The number of hockey-related injury emergency department visits of pa ents between 5 and 17 years of age (Alberta
minor hockey) was obtained from Alberta Health Services, Analy cs (DIMR) from April 1, 2014 to March 31, 2015.
With the use of the voluntary Alberta sport and recrea on code sub-classifica on system pa ents with a hockeyrelated injury (sport and recrea on code 054-hockey-Ice [default]) were iden fied.
The number of minor hockey registrants between the ages of 5 and 17 years in 2014-2015 season iden fied by year of
birth, by Hockey Alberta Zone/community and was obtained from Hockey Alberta.

DataLimita ons
As the collec on of the Alberta sport and recrea on code sub-classifica on is voluntary, all Alberta Health Zone captured hockey-related injury emergency department visits except the North Zone, excluding Redwater Health Centre.
Therefore, the actual number of hockey-related emergency department visits will be under represented.
The number of registrants by zone/community was selected to match the zone/communi es of Alberta Health Services.
Injuries treated at home, physicians oce, a er-hours clinics, urgent-care clinics, medi-centres available in the regions are not included in this report.

DataCategories
The injuries were assigned by body region based on the main diagnosis at the me of discharge from the emergency
department using the Interna onal Classifica on of Diseases and Related Health Problems, 10th Revision, Canada
Adapta on (ICD-10CA).

HockeyRelatedInjuriesinAlberta,EmergencyDepartmentVisits
Between April 1, 2014 and March 31, 2015 there were 7,914 hockey-related emergency department visits in Alberta.
Over half (53%, 4,199 visits) of the visits were children and youth of minor hockey ages, between the ages of 5 and 17
years.
Of the 4,199 emergency department visits involving hockey-related visits, 99% (4,143 visits) of the visits had an injury.
The remaining 1% had a non-injury code, i.e. asthma, pain of a joint, and headache.
This report focuses on hockey-related injury visits.

PercentofInjuries,RegistrantsandInjuryRateper10,000registrants

3000

16.0

2500

14.0
12.0

2000

Percentage

10.0

1500

8.0

1000

6.0
4.0

500

2.0
0.0

10

11

12

13

14

% of injuries

0.6

0.8

1.4

2.3

3.3

4.6

6.1

7.1

15.0 15.9 17.1 14.0 12.0

% of registrants

6.9

8.9

9.4

9.1

9.1

9.0

9.0

8.5

7.7

Rate per 10,000 registrants

71

82

130

223

316

452

597

746 1718 2017 2565 2374 2550

7.0

15
5.9

16
5.2

17

Rateper10,000registrants

18.0

4.2

Youth 15 years of age had the highest percent of injury emergency department visit with 17.1%, 708 visits. Children 7 years of age had the highest percent of registrants with Alberta Minor Hockey with 9.4%, 4,374 registrants.
When comparing the percent of injuries with the percent registrants, youth 15 and 17 years of age had almost 3
mes the percentage of injuries compared to registrants. Players 15 years of age accounted for 5.9% of the registraons yet accounted for 17.1% of the injuries. Player 17 years of age accounted for 4.2% of the registrants but had
12.0% of the injuries. The smallest ra o was children 5 years of age with ra o 1:0.08, with 6.9% of the registrants
and 0.6% of injuries.
The overall injury rate for hockey-related injuries was 888 visits per 10,000 registrants. Youth 15 years of age had the
highest visit rate two-half mes the overall rate with 2,565 visits per 10,000 registrants. This was closely followed by
those 17 years of age with a rate of 2,550 visits per 10,000 registrants.

InjuriesbyBodyRegion

1757

BodyRegion

Upper extremity

679
1195

Head/neck

626
845

Lower extremity

126
324

Thorax/back/abdomen

25

Multiple body
regions/other

All Injuries

22
1
0

Significant Injury

500

1000

1500

2000

NumberofEmergencyDepartment Visits

Of the 4,143 hockey-related injury visits, the body region most frequently injured involved the upper extremity with
42% (1,757 visits). This includes fractures, disloca ons/sprains/strains, cuts, and bruises to the shoulder, upper arm,
elbow, forearm, wrist, hand and fingers.
Injuries to the head/neck accounted for 29% (1,195 visits) of emergency department visits. This includes concussions,
fractures, internal head injuries, cuts and bruises to the head/scalp, face and neck.
Injuries to the lower extremity accounted for 20% (845 visits) of hockey-related emergency department visits. This
includes fractures, disloca ons/sprains/strains, cuts, and bruises to the hip, thigh, knee, shin, ankle, foot and toes.
Injuries to the thorax/back/abdomen accounted for 8% (324 visits). This includes fractures, intra-abdominal/organ
injuries, cuts, and bruises to the thorax/back or abdomen.
Injuries to mul ple body regions/other accounted for 1% (22 visits). Due to the small number of visits this body region
will not be further analysed.

SignificantInjury
Of the 4,143 hockey-related injury visits, 35% (1,449 visits) had a significant injury. This includes fractures and intracranial injuries. This doesnt include: disloca ons/sprains/strains of joints and ligaments, injuries of the nerves or blood
vessels, cuts, and bruises to any body region. The body region with the highest propor on of significant injuries is
head/neck, 52% (626 visits). Followed by upper extremity with 39% (679 visits), lower extremity with 15% (126 visits)
and thorax/back/abdomen with 8% significant injuries (25 visits).

HeadandNeckBodyRegionSignificantInjuries
Of the 1,195 visits as a result of an injury to the head and neck, 52% (626 visits) were significant injuries (intracranial
injuries and fractures). The majority 98% (616 visits) of injuries in this body region were intracranial injuries, mainly
concussions.

120

400.0
350.0

100

80

250.0
200.0

60

150.0

40

100.0
20

0
Number of ED visits
Rate per 10,000 registrants

Rateper10,000registrants

NumberofVisits

300.0

50.0

3.1

9.6

10

11

12

13

14

15

16

17

15

30

31

40

53

67

85

83

100

65

42

0.0

34.3 70.4 72.5 94.6 125.7 169.5 235.6 254.0 362.3 266.9 215.9

The overall rate for hockey-related significant intracranial injures was 132 visits per 10,000 registrants. Youth, 15 years
of age experienced a rate 3.5 mes higher than the overall rate, with the highest number and the highest rate of intracranial injury visits with 100 visits and a rate of 362.3 visits per 10,000 registrants. Youth 16 years of age had the second highest visits rate with 266.9 visits per 10,000 registrants but didnt have the second highest number of visits with
65 visits. Those 13 years of age had the second highest number of visits with 85 and a rate of 235.6 visits per 10,000
registrants.

UpperExtremityBodyRegionSignificantInjuries
Of the 1,757 visits as a result of an injury to the upper extremi es, 39% (679 visits) were significant injuries (fractures).
Fracture to the forearm accounted for 41% (274 visits), fractures to the shoulder and upper arm accounted for 34%
(231 visits) and fractures to the wrist/hand accounted for 25% (166 visits).

160

500.0

400.0
120
NumberofVisits

350.0
100

300.0

80

250.0
200.0

60

Rateper10,000 registrants

450.0

140

150.0
40
100.0
20
0
Number of ED visits

50.0
5
1

Rate per 10,000 registrants 3.1

6
4
9.6

10

11

12

13

14

15

16

17

15

20

33

52

148 145 107

82

51

0.0

9.1 21.1 35.1 47.3 78.2 131.6 410.2 443.7 387.7 336.8 262.2

The overall rate for hockey-related significant upper extremity injuries was 144 visits per 10,000 registrants. Youth, 14
years of age experienced a rate 3 mes that of the overall rate. Those 14 years of age had a visit rate of upper extremity fractures of 443.7 visits per 10,000 registrants with 145 visits. This was closely followed by those 13 years of age with
a rate of 410.2 visits per 10,000 registrants with 148 visits.

LowerExtremityBodyRegionSignificantInjuries
Of the 845 visits as a result of an injury to the lower extremi es, 15% (126 visits) were significant injuries (fractures).
Fracture to the lower leg including ankle accounted for 84% (1063 visits), fractures to the upper leg/femur accounted
for 10% (12 visits), fracture to the foot excluding ankle accounted for 6% (7 visits) and fractures to the lower limb, unspecified accounted for 1% (1 visit).

90.0

25

80.0
70.0
60.0
15
50.0
40.0
10
30.0

Rateper10,000 registrants

NumberofVisits

20

20.0

10.0
0
Number of ED visits

5
0

Rate per 10,000 registrants 0.0

6
1
2.4

10

11

12

13

14

15

16

17

21

21

23

18

11

0.0

2.3 11.7 4.7 14.2 19.0 22.8 58.2 64.3 83.3 73.9 56.6

The overall rate for hockey-related significant lower extremity injuries was 27 visits per 10,000 registrants. Youth, 15
years of age experienced a rate 3 mes that of the overall rate with a rate 83.3 visits per 10,000 registrants and 23 visits. This was closely followed by those 16 years of age with a rate of 73.9 visits per 10,000 registrants and 18 visits.