Concussion Symptoms and Return to Play Time in Youth, High School, and College American Football Athletes
Concussion Symptoms and Return to Play Time in Youth, High School, and College American Football Athletes
复制标题
DOI：
10.1001/jamapediatrics.2016.0073
复制
发表时间：
2016-07-01
期刊：
影响因子：
26.1
通讯作者：
Dompier, Thomas P.
中科院分区：
文献类型：
--
作者：
Kerr, Zachary Y.;Zuckerman, Scott L.;Dompier, Thomas P.
据我们所知，很少有研究对青少年的脑震荡进行调查，对脑震荡相关结果（即症状和恢复）的调查就更少了。目的研究和比较青少年、高中和大学橄榄球运动员的运动相关脑震荡结局（症状和恢复比赛）。设计、设置和参与者在2012年至2014年赛季期间，运动教练参加了每次训练和比赛，并报告了受伤情况。在这项描述性流行病学研究中，收集了来自青少年、高中和大学足球队的数据，并在2015年7月至2015年9月期间对数据进行了分析。青少年足球监测系统包括来自118支球队的3000多名5至14岁的青少年足球运动员，提供310个球队赛季（即每支球队提供1个赛季的数据）。国家运动治疗、损伤和结果网络项目包括96个中学足球项目，提供184个球队赛季。全国大学体育协会伤病监测项目包括34个大学橄榄球项目，提供71个球队赛季。我们计算了症状的平均数量，每种症状的患病率，以及脑震荡患者恢复比赛时间较长（即需要至少30天的参加限制）的比例。使用广义线性模型来评估竞争水平之间报告症状的平均数量的差异。逻辑回归模型估计，复出的几率少于24小时，至少30天。结果：在青少年、高中和大学水平的足球运动员中共报告了1429例运动相关脑震荡，平均（SD）为5.48（3.06）个症状。在所有级别中，15.3%的人在脑震荡后至少30天恢复比赛，3.1%的人在脑震荡后不到24小时恢复比赛。与青少年相比，高中运动员报告的脑震荡症状较多（β = 1.39; 95% CI, 0.55-2.24）。与大学运动员相比，青少年运动员在受伤后至少30天恢复比赛的几率更大（优势比，2.75;95% CI, 1.10-6.85）和高中运动员（优势比，2.89;95% CI, 1.61-5.19）。青少年运动员在受伤后24小时内恢复比赛的几率大于高中运动员（优势比，6.23;95% CI, 1.02-37.98）。结论和相关性不同比赛水平的脑震荡相关结果存在差异，这可能归因于遗传、生物学和/或发育差异，或脑震荡相关政策和方案、运动员训练管理和运动员信息披露方面的水平特异性差异。考虑到本研究未测量的每个竞争水平的许多组织、社会环境和政策相关差异，有必要进一步研究以验证我们的发现。
IMPORTANCE To our knowledge, little research has examined concussion across the youth/adolescent spectrum and even less has examined concussion-related outcomes (ie, symptoms and return to play).OBJECTIVE To examine and compare sport-related concussion outcomes (symptoms and return to play) in youth, high school, and collegiate football athletes.DESIGN, SETTING, AND PARTICIPANTS Athletic trainers attended each practice and game during the 2012 to 2014 seasons and reported injuries. For this descriptive, epidemiological study, data were collected from youth, high school, and collegiate football teams, and the analysis of the data was conducted between July 2015 and September 2015. The Youth Football Surveillance System included more than 3000 youth football athletes aged 5 to 14 years from 118 teams, providing 310 team seasons (ie, 1 team providing 1 season of data). The National Athletic Treatment, Injury, and Outcomes Network Program included 96 secondary school football programs, providing 184 team seasons. The National Collegiate Athletic Association Injury Surveillance Program included 34 college football programs, providing 71 team seasons.MAIN OUTCOMES AND MEASURES We calculated the mean number of symptoms, prevalence of each symptom, and the proportion of patients with concussions that had long return-to-play time (ie, required participation restriction of at least 30 days). Generalized linear models were used to assess differences among competition levels in the mean number of reported symptoms. Logistic regression models estimated the odds of return to play at less than 24 hours and at least 30 days.RESULTS Overall, 1429 sports-related concussions were reported among youth, high school, and college-level football athletes with a mean (SD) of 5.48 (3.06) symptoms. Across all levels, 15.3% resulted return to play at least 30 days after the concussion and 3.1% resulted in return to play less than 24 hours after the concussion. Compared with youth, a higher number of concussion symptoms were reported in high school athletes (beta = 1.39; 95% CI, 0.55-2.24). Compared with college athletes, the odds of return to play at least 30 days after injury were larger in youth athletes (odds ratio, 2.75; 95% CI, 1.10-6.85) and high school athletes (odds ratio, 2.89; 95% CI, 1.61-5.19). The odds of return to play less than 24 hours after injury were larger in youth athletes than high school athletes (odds ratio, 6.23; 95% CI, 1.02-37.98).CONCLUSIONS AND RELEVANCE Differences in concussion-related outcomes existed by level of competition and may be attributable to genetic, biologic, and/or developmental differences or level-specific variations in concussion-related policies and protocols, athlete training management, and athlete disclosure. Given the many organizational, social environmental, and policy-related differences at each level of competition that were not measured in this study, further study is warranted to validate our findings.