Objective We compared data from the National Collegiate Athletic Association (NCAA) Concussion Study (1999–2001) and the NCAA-Department of Defense Concussion Assessment, Research and Education (CARE) Consortium (2014–2017) to examine how clinical management, return to play (RTP) and risk of repeat concussion in collegiate football players have changed over the past 15 years. Methods We analysed data on reported duration of symptoms, symptom-free waiting period (SFWP), RTP and occurrence of within-season repeat concussion in collegiate football players with diagnosed concussion from the NCAA Study (n=184) and CARE (n=701). Results CARE athletes had significantly longer symptom duration (CARE median=5.92 days, IQR=3.02–9.98 days; NCAA median=2.00 days, IQR=1.00–4.00 days), SFWP (CARE median=6.00 days, IQR=3.49–9.00 days; NCAA median=0.98 days, IQR=0.00–4.00 days) and RTP (CARE median=12.23 days, IQR=8.04–18.92 days; NCAA median=3.00 days, IQR=1.00–8.00 days) than NCAA Study athletes (all p<0.0001). In CARE, there was only one case of repeat concussion within 10 days of initial injury (3.7% of within-season repeat concussions), whereas 92% of repeat concussions occurred within 10 days in the NCAA Study (p<0.001). The average interval between first and repeat concussion in CARE was 56.41 days, compared with 5.59 days in the NCAA Study (M difference=50.82 days; 95% CI 38.37 to 63.27; p<0.0001). Conclusion Our findings indicate that concussion in collegiate football is managed more conservatively than 15 years ago. These changes in clinical management appear to have reduced the risk of repetitive concussion during the critical period of cerebral vulnerability after sport-related concussion (SRC). These data support international guidelines recommending additional time for brain recovery before athletes RTP after SRC.

中文翻译：

---

大学足球运动员重返赛场和重复脑震荡风险：来自 NCAA 脑震荡研究（1999-2001）和 CARE 联盟（2014-2017）的比较分析

目标 我们比较了美国大学体育协会 (NCAA) 脑震荡研究 (1999-2001) 和 NCAA 国防部脑震荡评估、研究和教育 (CARE) 联盟 (2014-2017) 的数据，以研究临床管理如何回归到在过去的 15 年中，大学足球运动员的比赛 (RTP) 和重复脑震荡的风险发生了变化。方法 我们分析了 NCAA 研究 (n=184) 和 CARE (n=701) 确诊脑震荡的大学橄榄球运动员报告的症状持续时间、无症状等待期 (SFWP)、RTP 和赛季内重复脑震荡发生率的数据。 ）。结果 CARE运动员的症状持续时间显着延长（CARE中位数=5.92天，IQR=3.02-9.98天；NCAA中位数=2.00天，IQR=1.00-4.00天），SFWP（CARE中位数=6.00天，IQR=3.49-9.00天） ; NCAA 中位数 = 0.98 天，IQR=0.00–4.00 天）和 RTP（CARE 中位数=12.23 天，IQR=8.04–18.92 天；NCAA 中位数=3.00 天，IQR=1.00–8.00 天）比 NCAA 研究运动员（所有 p<0.0001）。在 CARE 中，只有 1 例在最初受伤后 10 天内重复脑震荡（占赛季内重复脑震荡的 3.7%），而在 NCAA 研究中，92% 的重复脑震荡发生在 10 天内（p<0.001）。CARE 中首次和重复脑震荡之间的平均间隔为 56.41 天，而 NCAA 研究中为 5.59 天（M 差异 = 50.82 天；95% CI 38.37 至 63.27；p<0.0001）。结论 我们的研究结果表明，与 15 年前相比，大学橄榄球的脑震荡管理更加保守。临床管理的这些变化似乎降低了运动相关脑震荡 (SRC) 后大脑脆弱关键时期重复性脑震荡的风险。这些数据支持国际指南，建议在 SRC 后运动员 RTP 之前有额外的时间让大脑恢复。