{ "abstract": "Background\n\nHead, face, and neck injuries impose a substantial burden for emergency departments (ED); the mechanisms driving them across the life course however remain poorly understood at the population level. Large-scale, integrated analysis spanning anatomical regions, injury mechanisms, age groups, settings, and associated products or environmental surfaces offers an opportunity to identify the patterns and vulnerable populations that smaller or shorter-term studies cannot resolve.Methods\n\nWe queried National Electronic Injury Surveillance System (NEISS) records from 2006 to 2025 for injuries to the head, face, eyes, mouth, neck, or ears. Demographics, anatomical region, injury setting, associated products or environmental surfaces, and ED disposition were extracted, and a rule-based narrative classifier assigned 1 of 17 injury mechanisms from free-text descriptions. Non-routine ED disposition was defined as admission, transfer, observation, or fatality. Analyses were descriptive and based on unweighted NEISS case records.Results\n\nAmong 2,345,287 ED presentations, representing 31.8% of all NEISS-coded visits, the head was most often injured (51.2%), followed by the face (28.2%). Annual volume rose 35.2% (105,727 in 2006 to 142,918 in 2025), driven mainly by head injuries (+ 83.4%). Median age was 14 years and 56.4% of patients were male, but among older adults (≥ 65 years), females predominated (60.6%). Falls were the leading mechanism (53.0% across subcategories). Most patients were treated and discharged (89.4%) and admission rate rose roughly 18-fold from toddlers (1.3%) to older adults (23.3%). Non-routine ED disposition increased with age, and syncope- or medical-related falls had the highest non-routine ED disposition rate (33.9%). The home was the most common injury setting (63.1%). Injury exposures varied by age group, with beds most common in infants, tables in toddlers, sports equipment in children and adolescents, and floors in older adults.Conclusions\n\nHead, face, and neck injuries represent a large and growing share of NEISS-coded ED presentations, with distinct patterns by age, sex, injury mechanism, setting, and clinical outcome. These findings may assist in the planning of targeted prevention strategies and future research on risk stratification for vulnerable age groups and injury mechanisms.", "abstract_shown": true, "affiliations": [ "Department of Plastic Surgery and Hand Surgery, Technical University of Munich, Munich, Germany. Michael.alfertshofer@tum.de.", "Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. Michael.alfertshofer@tum.de.", "Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.", "Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-Universität München, Munich, Germany.", "Department of Plastic Surgery and Hand Surgery, Technical University of Munich, Munich, Germany.", "Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.", "Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.", "Department of Preventive and Community Dentistry, Faculty of Dental Surgery, Rio de Janeiro State University, Rio de Janeiro, Brazil.", "Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.", "Department of Plastic and Reconstructive Surgery, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.", "Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Harvard University, Boston, MA, USA.", "Cleft and Craniofacial Clinic, Mass General Hospital for Children and Shriners Hospital for Children, Boston, MA, USA.", "Division of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Munich, Germany." ], "article_type": "research article", "arxiv": null, "author_total": 15, "authors": [ { "affs": [ 0, 1 ], "name": "Michael Alfertshofer" }, { "affs": [ 2 ], "name": "Cosima C Hoch" }, { "affs": [ 3 ], "name": "Dirk Nolte" }, { "affs": [ 4 ], "name": "Hans-Günther Machens" }, { "affs": [ 5 ], "name": "Leonard Knoedler" }, { "affs": [ 5 ], "name": "Shady Abu-Sirhan" }, { "affs": [ 6 ], "name": "Siti Rahmayanti" }, { "affs": [ 7, 8 ], "name": "Deise Caldas Kühlman" }, { "affs": [ 9 ], "name": "Jeffrey E Janis" }, { "affs": [ 10, 11 ], "name": "Zachary S Peacock" }, { "affs": [ 5 ], "name": "Steffen Koerdt" }, { "affs": [ 2 ], "name": "Sarina Bucher" }, { "affs": [ 5 ], "name": "Max Heiland" }, { "affs": [ 12 ], "name": "Nicholas Moellhoff" }, { "affs": [ 4 ], "name": "Samuel Knoedler" } ], "bibtex": "https://research.draconitic.com/paper/ffdvbb5rq52a7.bib", "cited_by": 0, "doi": "10.1186/s12873-026-01821-3", "fulltext_url": "https://europepmc.org/articles/PMC13685241", "id": "ffdvbb5rq52a7", "issns": [ "1471-227X" ], "landing_url": "https://europepmc.org/article/MED/42902187", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "lcc", "RC86-88.9" ], [ "lcc", "RC952-1245" ], [ "openalex", "2739|Injury Epidemiology and Prevention" ] ], "openalex": "W7222976379", "pdf_url": "https://europepmc.org/articles/PMC13685241?pdf=render", "pmcid": "PMC13685241", "pmid": "42902187", "published": "2026-10-20", "publisher": "BMC", "ris": "https://research.draconitic.com/paper/ffdvbb5rq52a7.ris", "sources": [ { "first_seen": "2026-10-30T12:19:32Z", "native_id": "MED:42902187", "source": "europepmc", "url": "https://europepmc.org/article/MED/42902187" }, { "first_seen": "2026-10-30T13:45:41Z", "native_id": "1966290923a3491f89e468103cb1cb1f", "source": "doaj", "url": "https://doi.org/10.1186/s12873-026-01821-3" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2739|Injury Epidemiology and Prevention", "subfield": "epidemiology-public-health" } ], "title": "Head, face, and neck injury patterns across the life course: a 20-year NEISS analysis of 2,345,287 emergency department visits in the U.S.", "title_text": "Head, face, and neck injury patterns across the life course: a 20-year NEISS analysis of 2,345,287 emergency department visits in the U.S.", "type": "peer-reviewed", "updated_at": "2026-10-30T13:45:41Z", "url": "https://research.draconitic.com/paper/ffdvbb5rq52a7", "venue": "BMC emergency medicine", "versions": [] }