Washington State's Lystedt law in concussion documentation in Seattle public high schools

J Athl Train. Jul-Aug 2014;49(4):486-92. doi: 10.4085/1062-6050-49.3.30. Epub 2014 May 28.

Abstract

Context: The Lystedt law requires high school athletes who have sustained a concussion to be removed from practice and play and not to be allowed to return until cleared by a medical professional.

Objective: To determine the effect of the Lystedt law on injury and concussion documentation in the Seattle public high schools.

Design: Cross-sectional study.

Setting: Seattle public high schools.

Patients or other participants: The numbers of students, aged 13 to 19 years in the 2008-2009, 2009-2010, and 2010-2011 school years, were 4348, 4925, and 4806, respectively.

Main outcome measure(s): All injuries documented in SportsWare by athletic trainers in Seattle public high schools. We evaluated all injuries, including concussions recorded during the 2008-2009 school year, before the Lystedt law, and during the 2 school years after the law took effect (2009-2010 and 2010-2011). Incidence rates before and after the law were estimated and compared.

Results: The concussion rate was -1.09% in 2008-2009, 2.26% in 2009-2010, and 2.26% in 2010-2011. A comparison of relative risks showed that the incidence rates of concussions were different before and 1 year after the Lystedt law (relative risk = 2.10; 95% confidence interval [CI] = 1.50, 2.93) and 2 years after the law (relative risk = 2.10; 95% CI = 1.49, 2.93). Overall, the mean number of days out of play after 2008-2009 was almost 7 days greater after the law took effect (difference = 6.9 days; 95% CI = 0.70, 13.1). For females, the mean number of days out of play after 2008-2009 was more than 17 days in 2009-2010 (difference = 17.2 days; 95% CI = 4.81, 29.5) and was more than 6 days in 2010-2011 (difference = 6.3 days; 95% CI = 1.62, 11.0).

Conclusions: The number of documented concussions more than doubled after the institution of the Lystedt law, which may be attributed to heightened awareness and closer monitoring.

Keywords: adolescents; concussion incidence; sports injuries.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Athletes*
  • Athletic Injuries / epidemiology*
  • Brain Concussion / epidemiology*
  • Cross-Sectional Studies
  • Documentation*
  • Female
  • Humans
  • Incidence
  • Male
  • Medical Records / legislation & jurisprudence*
  • Retrospective Studies
  • Schools / legislation & jurisprudence*
  • Schools / statistics & numerical data
  • Students*
  • Washington / epidemiology