Premorbid Risk Factors and Acute Injury Characteristics of Sport-Related Concussion Across the National Collegiate Athletic Association: Findings from the Concussion Assessment, Research, and Education (CARE) Consortium,Sports Medicine

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Premorbid Risk Factors and Acute Injury Characteristics of Sport-Related Concussion Across the National Collegiate Athletic Association: Findings from the Concussion Assessment, Research, and Education (CARE) Consortium
Sports Medicine ( IF 9.3 ) Pub Date : 2023-03-16 , DOI: 10.1007/s40279-023-01830-3
Allyssa K Memmini _{1,

2} , Kelly M Mosesso ₃ , Susan M Perkins ₃ , Benjamin L Brett _{4,

5} , Paul F Pasquina ₆ , Thomas W McAllister ₇ , Michael A McCrea _{4,

5} , Steven P Broglio ₂ ,

Affiliation

Background

Previous sport-related concussion research highlights post-injury characteristics that influence recovery trajectories; however, there is limited information regarding premorbid factors that affect sport-related concussion risk.

Objective

We aimed to (a) compare premorbid demographic factors among a large cohort of collegiate student athletes who did or did not sustain a sport-related concussion and (b) assess differences in acute injury characteristics based on biological sex and contact level.

Methods

We conducted a cohort study of university student athletes from 22 sports enrolled in the Concussion Assessment, Research, and Education (CARE) Consortium study from 2014 to 2021 (n = 1804 student athletes with sport-related concussions; n = 21,702 student athletes without sport-related concussions).

Results

Statistical analyses indicated student athletes who self-identified as Black (odds ratio [OR] = 1.61; 95% confidence interval [CI] = 1.42, 1.81) or multiracial (OR = 1.32; 95% CI 1.10, 1.59) demonstrated greater odds of experiencing sport-related concussions than White-identifying student athletes. Additional findings suggest male athletes (OR = 1.47; 95% CI 1.20, 1.81) and contact sport student athletes (OR = 1.40; 95% CI 1.16, 1.70) may be at increased odds for sport-related concussions if they were previously diagnosed with attention deficit hyperactive disorder. Notable post-injury characteristics across sexes included differences in the incident loss of consciousness (male: 5.9%, female: 2.6%; p < 0.001), post-traumatic amnesia (male: 13.6%, female: 5.1%; p < 0.001), and retrograde amnesia (male: 6.8%, female: 2.8%; p < 0.001). A greater proportion of contact-sport student athletes experienced an altered mental status (52.7%) than limited contact (36.2%) and non-contact (48.6%) [p < 0.001]. Last, student athletes participating at lower contact levels were more likely to have a longer delay in removal from activity following injury (contact: 73.6 ± 322.2 min; limited contact: 139.1 ± 560.0 min; non-contact: 461.4 ± 1870.8 min; p = 0.005).

Conclusions

The present study provides contemporary pre- and post-sport-related concussion injury characteristics using a considerably sized cohort of collegiate student athletes. These findings support previous work suggesting sport-related concussion results in complex individualized clinical presentations, which may influence management strategies.

中文翻译：

全国大学体育协会运动相关脑震荡的病前危险因素和急性损伤特征：来自脑震荡评估、研究和教育 (CARE) 联盟的调查结果

背景

之前与运动相关的脑震荡研究强调了影响恢复轨迹的受伤后特征；然而，关于影响运动相关脑震荡风险的病前因素的信息有限。

客观的

我们的目的是（a）比较一大批遭受或未遭受运动相关脑震荡的大学生运动员的病前人口统计因素，以及（b）根据生物性别和接触水平评估急性损伤特征的差异。

方法

我们对 2014 年至 2021 年参加脑震荡评估、研究和教育 (CARE) 联盟研究的 22 个运动项目的大学生运动员进行了一项队列研究（n = 1804 名患有与运动相关脑震荡的学生运动员；n = 21,702 名没有参加过运动的学生运动员） -相关的脑震荡）。

结果

统计分析表明，自认为是黑人（比值比 [OR] = 1.61；95% 置信区间 [CI] = 1.42, 1.81）或多种族（OR = 1.32；95% CI 1.10, 1.59）的学生运动员表现出更大的可能性比白人学生运动员经历与运动相关的脑震荡。其他研究结果表明，男性运动员（OR = 1.47; 95% CI 1.20, 1.81）和接触运动学生运动员（OR = 1.40; 95% CI 1.16, 1.70）如果之前被诊断出患有运动相关脑震荡，那么他们发生运动相关脑震荡的几率可能会增加注意力缺陷多动障碍。不同性别之间显着的受伤后特征包括意识丧失事件的差异（男性：5.9％，女性：2.6％；p < 0.001），创伤后遗忘症（男性：13.6％，女性：5.1％；p <0.001）和逆行性遗忘症（男性：6.8%，女性：2.8%；p < 0.001）。与有限接触运动 (36.2%) 和非接触运动 (48.6%) 相比，接触运动学生运动员 (52.7%) 经历精神状态改变的比例更高 [ p < 0.001]。最后，参与较低接触水平的学生运动员受伤后更有可能延迟较长时间退出活动（接触：73.6 ± 322.2 分钟；有限接触：139.1 ± 560.0 分钟；非接触：461.4 ± 1870.8 分钟；p = 0.005）。