The Epidemiology of Sports-Related Traumatic Brain Injuries in the United States: Recent Developments

Thurman, David J.; Branche, Christine M.; Sniezek, Joseph E.

doi:10.1097/00001199-199804000-00003

Cited by 283 publications

(153 citation statements)

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“…The large variance is attributable to original estimates including concussions that only involved LOC. 22,23 This highlights the difficulty with concussion epidemiology because of underreporting and the lack of widespread use of an injury surveillance system in youth sports. 24,25 With increasing access to recreational and organized (club and school) sports, as well as better awareness and recognition of the injury, the number of diagnosed concussions will likely increase.…”

Section: Epidemiology Of Concussionmentioning

confidence: 99%

Sport-Related Concussion in Children and Adolescents

Halstead¹,

Walter²

2010

Pediatrics

586

445

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Sport-related concussion is a "hot topic" in the media and in medicine. It is a common injury that is likely underreported by pediatric and adolescent athletes. Football has the highest incidence of concussion, but girls have higher concussion rates than boys do in similar sports. A clear understanding of the definition, signs, and symptoms of concussion is necessary to recognize it and rule out more severe intracranial injury. Concussion can cause symptoms that interfere with school, social and family relationships, and participation in sports. Recognition and education are paramount, because although proper equipment, sport technique, and adherence to rules of the sport may decrease the incidence or severity of concussions, nothing has been shown to prevent them. Appropriate management is essential for reducing the risk of long-term symptoms and complications. Cognitive and physical rest is the mainstay of management after diagnosis, and neuropsychological testing is a helpful tool in the management of concussion. Return to sport should be accomplished by using a progressive exercise program while evaluating for any return of signs or symptoms. This report serves as a basis for understanding the diagnosis and management of concussion in children and adolescent athletes.

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Section: Epidemiology Of Concussionmentioning

confidence: 99%

Sport-Related Concussion in Children and Adolescents

Halstead¹,

Walter²

2010

Pediatrics

586

445

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“…A study by the Centers for Disease Control and Prevention estimates that 300,000 SRCs occur annually in the United States. 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.…”

Section: Introductionmentioning

confidence: 99%

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

Murugavel

Cubon

Putukian

et al. 2014

Journal of Neurotrauma

106

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The extent of structural injury in sports-related concussion (SRC) is central to the course of recovery, long-term effects, and the decision to return to play. In the present longitudinal study, we used diffusion tensor imaging (DTI) to assess white matter (WM) fiber tract integrity within 2 days, 2 weeks, and 2 months of concussive injury. Participants were righthanded male varsity contact-sport athletes (20.2 -1.0 years of age) with a medically diagnosed SRC (no loss of consciousness). They were compared to right-handed male varsity non-contact-sport athletes serving as controls (19.9 -1.7 years). We found significantly increased radial diffusivity (RD) in concussed athletes (n = 12; paired t-test, tract-based spatial statistics; p < 0.025) at 2 days, when compared to the 2-week postinjury time point. The increase was found in a cluster of right hemisphere voxels, spanning the posterior limb of the internal capsule (IC), the retrolenticular part of the IC, the inferior longitudinal fasciculus, the inferior fronto-occipital fasciculus (sagittal stratum), and the anterior thalamic radiation. Post-hoc, univariate, between-group (controls vs. concussed), mixed-effects analysis of the cluster showed significantly higher RD at 2 days ( p = 0.002), as compared to the controls, with a trend in the same direction at 2 months ( p = 0.11). Results for fractional anisotropy (FA) in the same cluster showed a similar, but inverted, pattern; FA was decreased at 2 days and at 2 months postinjury, when compared to healthy controls. At 2 weeks postinjury, no statistical differences between concussed and control athletes were found with regard to either RD or FA. These results support the hypothesis of increased RD and reduced FA within 72 h postinjury, followed by recovery that may extend beyond 2 weeks. RD appears to be a sensitive measure of concussive injury.

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“…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 sports annually, and thus understanding the frequency of SRRCs in children and adolescents is important on a population level. 1,8 One challenge in calculating the incidence of SRRCs is that injured youth may not receive treatment, or may receive care from a variety of providers including certified athletic trainers (ATCs), primary care, and emergency medicine physicians.…”

mentioning

confidence: 99%

“…5 This estimate was based on the Injury Supplement to the 1991 National Health Interview Survey, which defined TBI as a head injury with loss of consciousness, then inflated the number using the estimated proportion of concussions without loss of consciousness. 3,10 In addition to being based on selfreported data from assessments >2 decades ago, the range is wide. Despite these profound methodologic limitations, this estimate is widely cited by numerous authors.…”

mentioning

confidence: 99%

Sports- and Recreation-Related Concussions in US Youth

et al. 2016

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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 ...

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The Epidemiology of Sports-Related Traumatic Brain Injuries in the United States: Recent Developments

Cited by 283 publications

References 0 publications

Sport-Related Concussion in Children and Adolescents

Sport-Related Concussion in Children and Adolescents

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

Sports- and Recreation-Related Concussions in US Youth

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