Incidence and Risk Factors for Concussion in High School Athletes, North Carolina, 1996-1999

Abstract

A prospective cohort study was used to quantify risk factors for sports concussions. Analysis was based on a stratified cluster sample of North Carolina high school athletes followed during 1996-1999. Clustering was by school and sport, and the sample included 15,802 athletes with 1-8 seasons of follow-up per athlete. Concussion rates were estimated for 12 sports, and risk factors were quantified using generalized Poisson regression. Concussion rates ranged from 9.36 (95% confidence interval: 1.93, 16.80) per 100,000 athlete-exposures in cheerleading to 33.09 (95% confidence interval: 24.74, 41.44) per 100,000 athlete-exposures in football, where "athlete-exposure" is one athlete participating in one practice or game. The overall rate of concussion was 17.15 (95% confidence interval: 13.30, 21.00) per 100,000 athlete-exposures. Cheerleading was the only sport for which the practice rate was greater than the game rate. Almost two thirds of cheerleading concussions involved two-level pyramids. Concussion rates were elevated for athletes with a history of concussion, and they increased with the increasing level of body contact permitted in the sport. After adjustment for sport, body mass index, and year in school, history of concussion(s) remained a moderately strong risk factor for concussion (rate ratio = 2.28, 95% confidence interval: 1.24, 4.19). The fact that concussion history is an important predictor of concussion incidence, even in this young population, underscores the importance of primary prevention efforts, timely identification, and careful clinical management of these injuries.

Epidemiology of Sudden Death in Young, Competitive Athletes Due to Blunt Trauma

“…This sequence of events is consistent with "second-impact syndrome." [34][35][36][37][38][39] These athletes were 14 to 18 years of age, and all competed at the high school level; 9 were white, 5 black, and 3 Hispanic.…”

A Longitudinal Diffusion Tensor Imaging Study Assessing White Matter Fiber Tracts after Sports-Related Concussion

“…1 However, this study only included concussions for which the person reported loss of consciousness (LOC), which is thought to characterize only a fraction of SRCs. 2,3 Given that athletes often do not report their injury, a more accurate approximation may be that 1.6-3.8 million SRCs occur each year, including concussions, for which no medical treatment is sought. statement affirm that: ''a concussion may result in neuropathologic injury, but the acute clinical symptoms largely reflect a functional disturbance rather than structural injury.''…”

Intérêt du port d’un protège-dents dans la diminution de l’incidence et/ou de la gravité des commotions cérébrales dans le sport

“…Le risque de SRC augmente avec la dureté de la surface [54] ; -antécédents de SRC. Un individu ayant déjà présenté une SRC a 3 à 6 fois plus de risque d'être victime d'une SRC qu'un individu qui n'en a jamais eu [31,37,54,57,58].…”

“…; -l'absence de standardisation des taux de SRC (nombre de SRC par mille expositions, par heure de jeu, etc.) ; -l'absence d'information quant aux antécédents de SRC des sujets de l'étude (sachant que le fait d'avoir déjà eu une SRC augmenterait le risque d'en avoir une autre) [31,37,54,57,58] ; -l'absence de mesure et de contrôle de facteurs de confusion tels que les autres équipements de protection utilisés, le contexte de pratique de l'activité, la musculature, etc.…”