Risk Factors Associated With Sustaining a Sport-related Concussion: An Initial Synthesis Study of 12,320 Student-Athletes

Brett, Benjamin L.; Kuhn, Andrew W; Yengo‐Kahn, Aaron M.; Solomon, Gary S.; Zuckerman, Scott L.

doi:10.1093/arclin/acy006

Cited by 38 publications

(36 citation statements)

References 46 publications

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“…Prior work has consistently demonstrated that individuals with previous concussions are at increased risk to sustain a future concussion. [7][8][9][10][11] Our present findings are consistent in magnitude with the majority of these findings (~2-3 times higher risk of future sports-related concussion with any prior history of concussion). However, in contrast to prior work, history of concussion was not retained in multivariate models in this sample.…”

Section: Sports-related Concussion Risk Factorssupporting

confidence: 89%

“…Prior research indicates that the risk of sustaining a sports-related concussion is anywhere from 1.75 to 11 times greater for those with a history of one or more prior concussions. [7][8][9][10][11] In one of the largest retrospective studies to date (n = 12,320 participants), the odds of sustaining a sports-related concussion was 10.65 times greater than for those with a history than those without. 8 Therefore, while the specific magnitude of this effect is not necessarily clear, it is apparent that prior sports-related concussion is a predisposing factor.…”

Section: Introductionmentioning

confidence: 99%

“…This study identified sports-related concussion history as the most indicative risk factor, with level of play, history of headache treatment, contact sport participation, and ADHD/LD as additional risk factors. 8 One previously uninvestigated, or unreported, potential risk factor is the role of sleep. Currently the National Sleep Foundation recommends that teenagers (14-17 years old) and young adults (18-25 years), the populations in whom most sports-related concussion research is currently conducted, obtain 8-10 or 7-9 hours of sleep per night respectively.…”

Section: Introductionmentioning

confidence: 99%

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Insomnia and daytime sleepiness: risk factors for sports-related concussion

et al. 2019

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Objective/Background: Poor quality and inadequate sleep are associated with impaired cognitive, motor, and behavioral components of sport performance and increased injury risk. While prior work identifies sports-related concussions as predisposing factors for poor sleep, the role of sleep as a sports-related concussion risk factor is unknown. The purpose of this study was to quantify the effect of poor sleep quality and insomnia symptoms on future sports-related concussion risk. Patients/Methods: 190 NCAA Division-1 athletes completed a survey battery, including the Insomnia Sleep Index (ISI) and National Health and Nutrition Examination Survey (NHANES) Sleep module. Univariate risk ratios for future sports-related concussions were computed with ISI and NHANES sleepiness scores as independent predictors. An additional multiple logistic regression model including sport, sports-related concussion history, and significant univariate predictors jointly assessed the odds of sustaining a concussion. Results: Clinically moderate-to-severe insomnia severity (RR = 3.13, 95% CI: 1.320-7.424, p = 0.015) and excessive daytime sleepiness two or more times per month (RR = 2.856, 95% CI: 0.681-11.977, p = 0.037) increased concussion risk. These variables remained significant and comparable in magnitude in a multivariate model adjusted for sport participation. Conclusion: Insomnia and daytime sleepiness are independently associated with increased sports-related concussion risk. More completely identifying bidirectional relationships between concussions and sleep requires further research. Clinicians and athletes should be cognizant of this relationship and take proactive measures-including assessing and treating sleepdisordered breathing, limiting insomnia risk factors, improving sleep hygiene, and developing daytime sleepiness management strategies-to reduce sports-related concussion risk and support overall athletic performance.

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Section: Sports-related Concussion Risk Factorssupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Insomnia and daytime sleepiness: risk factors for sports-related concussion

et al. 2019

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“…48,49 We also examined risk factors for football-related concussion in this sample of youth athletes, finding that both history of prior concussion and history of depression were associated with greater risk for incident concussion. History of prior concussion has been reported as a risk factor for concussion in multiple prior studies, [23][24][25][26] likely owing to its function as a marker of risk. In other words, a prior history of concussion suggests a greater propensity to concussion, whether owing to genetic factors or environmental exposure (such as style of play or position).…”

Section: Discussionmentioning

confidence: 99%

Concussion Incidence, Duration, and Return to School and Sport in 5- to 14-Year-Old American Football Athletes

Chrisman

Lowry

Herring

et al. 2019

The Journal of Pediatrics

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Objective To collect prospective data on concussion incidence, risk factors, duration of symptoms, and return to school and sport in 5-to 14-year-old American football participants. Study design We conducted a prospective cohort study over 2 years collecting data during two 10-week fall seasons. Youth with concussion were followed to determine time to return to school, sport, and baseline level of symptoms. Logistic regression was used to estimate the risk of sustaining a concussion associated with baseline demographic factors. Time to return to school, sport, and baseline symptoms were analyzed using Kaplan-Meier survival curves. Results Of 863 youth followed (996 player-seasons), 51 sustained a football-related concussion, for an athletelevel incidence of 5.1% per season. Youth with history of concussion had a 2-fold increased risk for sustaining an incident concussion (OR, 2.2; 95% CI, 1.1-4.8). Youth with depression had a 5-fold increased risk of concussion (OR, 5.6; 95% CI, 1.7-18.8). After a concussion, 50% of athletes returned to school by 3 days, 50% returned to sport by 13 days, and 50% returned to a baseline level of symptoms by 3 weeks. Conclusions Concussion rates in this study were slightly higher than previously reported, with 5 of every 100 youth sustaining a football-related concussion each season. One-half of youth were still symptomatic 3 weeks after injury. Further research is needed to address the risk of concussion in youth football.

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“…Most research on comorbid conditions in relation to concussion outcome has focused on depression and anxiety [14,35,37,[41][42][43][44]. More and more work has shown a link between behavioural disorders (such as ADHD) and learning disabilities as contributing factors to concussion symptom and severity presentation [45][46][47][48]. As an example, participants with ADHD were significantly more disabled after suffering a concussion than were control participants without ADHD, even when controlling for age and sex [49][50][51][52][53].…”

Section: Agementioning

confidence: 99%

Interaction between Age, Sex, and Mental Health Status as Precipitating Factors for Symptom Presentation in Concussed Individuals

Lariviere

Bureau

Marshall³

et al. 2019

Journal of Sports Medicine

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Concussions are among the most common neurological conditions, with emergency departments and sports injury clinics seeing hundreds of patients each year. The consideration of risk factors such as age, sex, and comorbid conditions are very important when looking at individual physiological and psychological outcomes after a concussion. The purpose of this study was to look at four comorbid conditions (depression, anxiety, behavioural disorder, or learning disability) and identify any interactions with age and sex in symptom presentation after suffering a concussion. A total of 4,865 participants from the CCMI (Complete Concussion Management Inc.) dataset were used with 1,577 self-identified with a diagnosis of anxiety, depression, a behavioural disorder, or a learning disability. Fixed-factor analyses of variance were used with age and sex as fixed, grouping factors and symptom total and severity as dependent measures. For the individuals who did not have one of the 4 mental health conditions (3,288 control participants), symptom total and symptom severity increased with age (p<0.05), and females showed more symptoms and a higher symptom severity than males across all ages (p<0.05). A diagnosis of anxiety or depression exacerbated total symptoms and symptom severity from 25–50% above control levels in the 19 and under age groups, while depression or anxiety exacerbated total symptoms and severity by 10–15% in males more than females over 20. A diagnosis of a behavioural disorder or a learning disability exacerbated symptom severity by approximately 50% above control levels in 13–19–year-old females and in males of 30 years and older. This study highlights how the presence of a mental health condition may alter concussion symptom presentation dependent on age and sex. The identification of risk factors and how they may interact can be of great value to health care providers who manage concussion symptoms and recovery.

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Risk Factors Associated With Sustaining a Sport-related Concussion: An Initial Synthesis Study of 12,320 Student-Athletes

Cited by 38 publications

References 46 publications

Insomnia and daytime sleepiness: risk factors for sports-related concussion

Insomnia and daytime sleepiness: risk factors for sports-related concussion

Concussion Incidence, Duration, and Return to School and Sport in 5- to 14-Year-Old American Football Athletes

Interaction between Age, Sex, and Mental Health Status as Precipitating Factors for Symptom Presentation in Concussed Individuals

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