Sports- and Recreation-Related Concussions in US Youth

Abstract

The incidence of sports-and recreation-related concussions (SRRCs) in the United States is unknown. More than 44 million youth participate in sports annually, thus understanding the frequency of SRRCs in children is important on a population level. Our objective was to determine the number of SRRCs occurring annually among US youth ≤18 years old. METHODS:We identified SRRCs using 3 national databases: MarketScan, National Electronic Injury Surveillance System, and National High School Sports Related Injury Surveillance System, Reporting Injury Online. We determined the number of SRRCs seen in health care settings (outpatient, inpatient, and emergency department) and SRRCs reported to certified high school athletic trainers (ATCs). We used these data and findings in recently published literature to generate a national estimate of SRRCs. RESULTS:We estimate that between 1.1 and 1.9 million SRRCs occur annually in US children aged ≤18 years. Most children with SRRCs, 511 590 to 1 240 972, were not seen in health care settings. Of children with SRRCs seen in health care settings, most were seen as outpatients with 377 978 visits, compared with between 115 479 and 166 929 ED visits, and between 2886 and 4936 hospitalizations. CONCLUSIONS:This study provides the most accurate and precise estimate to date of the number of concussions among US children annually. SRRCs are a common injury in children. Providers in all health care settings need to be trained in concussion care. There is a need for better surveillance to enhance our understanding of the epidemiology of concussions in youth. Dr Bryan conducted the data gathering and analysis with Dr Rowhani-Rahbar and led the manuscript writing; Dr. Rowhani-Rahbar conducted the data gathering and analysis with Dr Bryan and contributed to the manuscript preparation and intellectual content; Dr Comstock provided data and feedback on manuscript preparation; Dr Rivara conceived of the study and supervised throughout data gathering, analysis, and manuscript preparation; and all authors approved the fi nal manuscript as submitted. WHAT'S KNOWN ON THIS SUBJECT: Sports-and recreation-related concussions (SRRCs) are a common source of morbidity in children. Many of these injuries are not treated within health care settings. It is unknown how many SRRCs occur annually in the US. DOI WHAT THIS STUDY ADDS:We estimate between 1.1 and 1.9 million SRRCs occur annually in US children ≤18 years old. The magnitude of this number emphasizes the need for better national injury surveillance of the incidence of SRRCs.by guest on May 10, 2018 http://pediatrics.aappublications.org/ Downloaded from BRYAN et alConcussions, a form of traumatic brain injury (TBI), are common in children, with sports and recreation as a leading cause in this age group. 1, 2 The incidence of sports-and recreation-related concussions (SRRCs) in the United States is unknown; however, most epidemiologic studies indicate that a large number of SRRCs occur each year. [3][4][5][6][7] More than 44 million youth participate in ...

Concussion attitudes, behaviors, and education among youth ages 12–17: Results from the 2014 YouthStyles survey

“…A cross-sectional survey by Register-Mihalik et al (2013), using a convenience sample of high school athletes from nine different states, found that more than half (53%) of athletes recalled sustaining at least one possible concussion. Using existing databases, Bryan, Rowhani-Rahbar, Comstock, Rivara, et al (2016) estimated the annual incidence of sports- and recreation-related concussion among youth ages 18 and younger and found that between 1.1 and 1.9 million occurred each year.…”

American Medical Society for Sports Medicine position statement on concussion in sport

“…A recent report using data from emergency room visits, office visits and a high school injury surveillance system estimated 1.0–1.8 million SRCs per year in the 0–18 years age range and a subset of about 400 000 SRCs in high school athletes 11. While this estimate is likely accurate, determining actual sport-based or activity-based concussion rates is difficult.…”

“…Seasonal or annual risk may be a more readily understood concept. It is estimated that over 50% of concussions in high school-aged youth are not related to organised sports and only 20% are related to organised school team sports 11. Between 2% and 15% of athletes participating in organised sports will suffer a concussion during one season12–29 (table 2).…”

Sports-related concussions and subconcussive impacts in athletes: incidence, diagnosis, and the emerging role of EPA and DHA

“…In the United States, there were 1.1 million football players, 36,000 ice hockey players and a total of over 7.8 million high school sport athletes in (NFHS 2016. Bryan et al (2016) estimated between 1.1-1.9 million sport-related and recreation-related concussions occur annually in those ≤18 years of age. This large range is due to the majority of US youth who likely sustained a concussion but were not examined by a qualified professional and thus, were not accurately diagnosed (Bryan et al 2016).…”