New and Recurrent Concussions in High-School Athletes Before and After Traumatic Brain Injury Laws, 2005-2016

doi:10.2105/AJPH.2017.304056

. 2017 Dec;107(12):1916-1922.

doi: 10.2105/AJPH.2017.304056. Epub 2017 Oct 19.

New and Recurrent Concussions in High-School Athletes Before and After Traumatic Brain Injury Laws, 2005-2016

Jingzhen Yang¹, R Dawn Comstock¹, Honggang Yi¹, Hosea H Harvey¹, Pengcheng Xun¹

Affiliations

Affiliation

¹ Jingzhen Yang is with the Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, and Department of Pediatrics, College of Medicine and Department of Epidemiology, College of Public Health, The Ohio State University, Columbus. R. Dawn Comstock is with the Department of Epidemiology, The Colorado School of Public Health, and the Department of Pediatrics, Emergency Medicine, School of Medicine, University of Colorado Anschutz, Aurora. Honggang Yi is with the Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, and the Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province, China. Hosea H. Harvey is with the Beasley School of Law, Temple University, Philadelphia, PA. Pengcheng Xun is with the Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington.

PMID: 29048967
PMCID: PMC5678378
DOI: 10.2105/AJPH.2017.304056

New and Recurrent Concussions in High-School Athletes Before and After Traumatic Brain Injury Laws, 2005-2016

Jingzhen Yang et al. Am J Public Health. 2017 Dec.

. 2017 Dec;107(12):1916-1922.

doi: 10.2105/AJPH.2017.304056. Epub 2017 Oct 19.

Authors

Jingzhen Yang¹, R Dawn Comstock¹, Honggang Yi¹, Hosea H Harvey¹, Pengcheng Xun¹

Affiliation

¹ Jingzhen Yang is with the Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, and Department of Pediatrics, College of Medicine and Department of Epidemiology, College of Public Health, The Ohio State University, Columbus. R. Dawn Comstock is with the Department of Epidemiology, The Colorado School of Public Health, and the Department of Pediatrics, Emergency Medicine, School of Medicine, University of Colorado Anschutz, Aurora. Honggang Yi is with the Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, and the Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province, China. Hosea H. Harvey is with the Beasley School of Law, Temple University, Philadelphia, PA. Pengcheng Xun is with the Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington.

PMID: 29048967
PMCID: PMC5678378
DOI: 10.2105/AJPH.2017.304056

Abstract

Objectives: To examine the trends of new and recurrent sports-related concussions in high-school athletes before and after youth sports traumatic brain injury laws.

Methods: We used an interrupted time-series design and analyzed the concussion data (2005-2016) from High School Reporting Injury Online. We examined the trends of new or recurrent concussion rates among US representative high-school athletes participating in 9 sports across prelaw, immediate-postlaw, and postlaw periods by using general linear models. We defined 1 athlete exposure as attending 1 competition or practice.

Results: We included a total of 8043 reported concussions (88.7% new, 11.3% recurrent). The average annual concussion rate was 39.8 per 100 000 athlete exposures. We observed significantly increased trends of reported new and recurrent concussions from the prelaw, through immediate-postlaw, into the postlaw period. However, the recurrent concussion rate showed a significant decline 2.6 years after the laws went into effect. Football exhibited different trends compared with other boys' sports and girls' sports.

Conclusions: Observed trends of increased concussion rates are likely attributable to increased identification and reporting. Additional research is needed to evaluate intended long-term impact of traumatic brain injury laws.

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Figures

**FIGURE 1—**
**Trend of New Concussion Rates Among US High-School Athletes Across a Period From Pre- to Postlaw: United States, Academic Years 2005–2006 Through 2015–2016** *Note.* AE = athlete exposure with attending 1 competition or practice defined as 1 AE; CI = confidence interval.

**FIGURE 2—**
**Trend of Recurrent Concussion Rates Among US High-School Athletes Across a Period From Pre- to Postlaw: United States, Academic Years 2005–2006 Through 2015–2016** *Note.* AE = athlete exposure with attending 1 competition or practice defined as 1 AE; CI = confidence interval.

**FIGURE 3—**
**Trend of Concussion Rates Among US High-School Athletes by Gender Across a Period From Pre- to Postlaw: United States, Academic Years 2005–2006 Through 2015–2016** *Note.* AE = athlete exposure with attending 1 competition or practice defined as 1 AE; CI = confidence interval.

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References

1. Bryan MA, Rowhani-Rahbar A, Comstock RD et al. Sports- and recreation-related concussions in US youth. Pediatrics. 2016;138(1):e20154635. - PubMed
1. Centers for Disease Control and Prevention. Nonfatal sports and recreation related traumatic brain injuries among children and adolescents treated in emergency departments in the United States, 2001–2009. MMWR Morb Mortal Wkly Rep. 2011;60(39):1337–1342. - PubMed
1. Marar M, McIlvain NM, Fields SK, Comstock RD. Epidemiology of concussions among United States high school athletes in 20 sports. Am J Sports Med. 2012;40(4):747–755. - PubMed
1. Harmon KG, Drezner JA, Gammons M et al. American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med. 2013;47(1):15–26. - PubMed
1. Taylor HG, Dietrich A, Nuss K et al. Post-concussive symptoms in children with mild traumatic brain injury. Neuropsychology. 2010;24(2):148–159. - PMC - PubMed

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[1] Bryan MA, Rowhani-Rahbar A, Comstock RD et al. Sports- and recreation-related concussions in US youth. Pediatrics. 2016;138(1):e20154635. - PubMed

[2] Bryan MA, Rowhani-Rahbar A, Comstock RD et al. Sports- and recreation-related concussions in US youth. Pediatrics. 2016;138(1):e20154635. - PubMed

[3] Centers for Disease Control and Prevention. Nonfatal sports and recreation related traumatic brain injuries among children and adolescents treated in emergency departments in the United States, 2001–2009. MMWR Morb Mortal Wkly Rep. 2011;60(39):1337–1342. - PubMed

[4] Centers for Disease Control and Prevention. Nonfatal sports and recreation related traumatic brain injuries among children and adolescents treated in emergency departments in the United States, 2001–2009. MMWR Morb Mortal Wkly Rep. 2011;60(39):1337–1342. - PubMed

[5] Marar M, McIlvain NM, Fields SK, Comstock RD. Epidemiology of concussions among United States high school athletes in 20 sports. Am J Sports Med. 2012;40(4):747–755. - PubMed

[6] Marar M, McIlvain NM, Fields SK, Comstock RD. Epidemiology of concussions among United States high school athletes in 20 sports. Am J Sports Med. 2012;40(4):747–755. - PubMed

[7] Harmon KG, Drezner JA, Gammons M et al. American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med. 2013;47(1):15–26. - PubMed

[8] Harmon KG, Drezner JA, Gammons M et al. American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med. 2013;47(1):15–26. - PubMed

[9] Taylor HG, Dietrich A, Nuss K et al. Post-concussive symptoms in children with mild traumatic brain injury. Neuropsychology. 2010;24(2):148–159. - PMC - PubMed

[10] Taylor HG, Dietrich A, Nuss K et al. Post-concussive symptoms in children with mild traumatic brain injury. Neuropsychology. 2010;24(2):148–159. - PMC - PubMed

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New and Recurrent Concussions in High-School Athletes Before and After Traumatic Brain Injury Laws, 2005-2016

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New and Recurrent Concussions in High-School Athletes Before and After Traumatic Brain Injury Laws, 2005-2016

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