BACKGROUND: There are few epidemiologic studies of catastrophic baseball 
injuries.
PURPOSE: To develop a profile of catastrophic injuries in baseball players and 
to describe relevant risk factors.
STUDY DESIGN: Retrospective cohort study.
METHODS: The authors reviewed 41 incidents of baseball injuries reported to the 
National Center for Catastrophic Sports Injury Research from 1982 until 2002.
RESULTS: There were an estimated 1.95 direct catastrophic injuries per year, or 
0.43 injuries per 100,000 participants. The most common mechanisms of injury 
were a collision of fielders (9) or of a base runner and a fielder (8), a 
pitcher hit by a batted ball (14), and an athlete hit by a thrown ball (4). 
Catastrophic injuries included 23 severe head injuries, 8 cervical injuries, 3 
cases of commotio cordis, and 2 cases each of a collapsed trachea and facial 
fractures. Three athletes sustained a severe head injury and facial fractures. 
Ten of the 41 injuries were fatalities.
CONCLUSIONS: Suggestions for reducing catastrophic injuries in baseball include 
teaching proper techniques to avoid fielding and baserunning collisions, 
protecting the pitcher via a combination of screens and/or helmets with 
faceguards, continued surveillance and modifications of the bat and ball, 
eliminating headfirst slides, and continued analysis of chest protectors and 
automatic external defibrillators for commotio cordis.