Purpose Describe results from detailed interviews with athletes, families, and school representatives regarding fatal and severe non-fatal (catastrophic) sport injuries.

Methods The National Centre for Catastrophic Sport Injury Research conducts national surveillance of sport-related catastrophic injuries, including severe brain, spine, and internal organ injuries. Detailed telephone interviews were conducted to supplement surveillance. Athletes, families, and school staff were interviewed for information about the athlete’s injury circumstances, medical history, medical care received, and outcome.

Results 160 injured athletes were identified between 7/1/2013–12/31/2016 (45.7 injuries/year); 33 (21%) died. Most athletes were football players (n=128, 80%) and had a spinal cord injury (n=76, 48%) or brain injury (n=62, 39%). Contact information was available for 120 injured athletes (75%), and 31 interviews were conducted regarding 20 athletes (17%). Most of the 20 athletes were in high school (n=18, 90%) and male (n=18, 90%). All had received pre-season physicals. For 18 helmeted sport athletes, 28% experienced an initial top of the head impact (n=5), and 61% (n=11) were injured during a tackle. Most were able to walk immediately post-injury (n=11, 55%). Three (15%) injuries were attributed to a called/suspected rule violation. EMS was onsite for 45% of events (n=9), and transported 75% of injured athletes (n=15). Of 14 athletes (70%) who survived, most did not recover, reporting functional impairments (n=8, 57%) and residual paralysis (n=3, 21%). Most injuries were thought to be preventable (n=12, 60%).

Conclusions Most athletes did not fully recover, and most injuries were thought to be preventable. Interview participation was low and future research should explore additional methods of learning about catastrophic sport injuries.

Significance Catastrophic sport injuries have a large impact on athletes, families, schools, and the community. A better understanding of these injuries, including event circumstances, athlete’s medical history, and immediate care provided, may illuminate targeted prevention and treatment efforts.