Catastrophic head injuries in high school and college football players
Catastrophic head injuries in high school and college football players
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DOI：
10.1177/0363546507299239
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发表时间：
2007-07-01
影响因子：
4.8
通讯作者：
Mueller, Frederick O.
中科院分区：
文献类型：
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作者：
Boden, Barry P.;Tacchetti, Robin L.;Mueller, Frederick O.
研究设计：病例系列，证据水平，4。方法：回顾1989年9月至2002年6月国家灾难性运动损伤研究中心报告的94例严重足球头部损伤事件。结果：在研究期间，学校足球运动员每年平均发生7.23例(标准差=2.05)的直接高中和大学灾难性头部损伤。在危险比为3.28(95%可信区间：0.81，13.3)的情况下，每10万(95%可信区间：0.54，0.81/10万)高中生中有0.67人受伤，每10万(95%可信区间：0.0，0.49)大学参与者中有0.21人受伤。硬膜下血肿75例，硬膜下血肿伴弥漫性脑水肿10例，弥漫性脑水肿5例，动静脉畸形或动脉瘤4例。59%的接触者报告称，这名运动员以前有头部损伤史，其中71%发生在与灾难性事件相同的季节内。39%的运动员(54人中有21人)在比赛中出现了先前头部受伤后残留的神经症状。8例(9%)死亡，46例(51%)永久性神经损伤，36例(40%)完全康复的严重损伤。大多数球员头部受到严重冲击，无论是在拦截还是被拦截中。结论：自20世纪70年代初现代足球头盔问世以来，足球运动中灾难性头部损伤的发生率一直很低。橄榄球运动中灾难性头部损伤的发生率在高中阶段比大学水平高得多。尽管这种差异的原因尚不清楚，但高得令人无法接受的高中球员在打球时有先前头部受伤的残留症状。教练员、运动员、运动训练师和医务人员需要坚持这一指导方针，即应强烈劝阻因头部受伤而出现任何神经症状的运动员重返赛场。
Background: Catastrophic head injuries in football are rare but tragic events.Purpose: To update the profile of catastrophic head injuries in high school and college football players and to describe relevant risk factors.Study Design: Case series; Level of evidence, 4.Methods: We reviewed 94 incidents of severe football head injuries reported to the National Center for Catastrophic Sports Injury Research during 13 academic years (September 1989 through June 2002).Results: In the study period there were an average of 7.23 (standard deviation = 2.05) direct high school and college catastrophic head injuries in scholastic football participants per year. There were 0.67 injuries per 100 000 (95% confidence interval: 0.54, 0.81 per 100 000) high school and 0.21 injuries per 100 000 (95% confidence interval: 0.0, 0.49 per 100 000) college participants for a risk ratio of 3.28 (95% confidence interval: 0.81, 13.3). The injuries resulted in subdural hematoma in 75 athletes, subdural hematoma with diffuse brain edema in 10 athletes, diffuse brain edema in 5 athletes, and arteriovenous malformation or aneurysm in 4 athletes. Fifty-nine percent of the contacts reported that the athlete had a history of a previous head injury, of which 71% occurred within the same season as the catastrophic event. Thirty-nine percent of the athletes (21 of 54) were playing with residual neurologic symptoms from the prior head injury. There were 8 (9%) deaths as a result of the injury, 46 (51%) permanent neurologic injuries, and 36 (40%) serious injuries with full recovery. Most players sustained a major impact to the head either from tackling or being tackled.Conclusion: The incidence of catastrophic head injuries in football has remained low since the advent of the modern day football helmet in the early 1970s. The incidence of catastrophic head injuries in football is dramatically higher at the high school level than at the college level. Although the reason for this discrepancy is unclear, an unacceptably high percentage of high school players were playing with residual symptoms from a prior head injury. Coaches, athletes, athletic trainers, and medical personnel need to adhere to the guideline that an athlete with any neurologic symptoms from a head injury should be strongly discouraged from returning to play.