EPIDEMIOLOGY OF NECK INJURIES ACCOMPANYING SPORT CONCUSSIONS IN YOUTH OVER A 13-YEAR PERIOD IN A COMMUNITY-BASED HEALTHCARE SYSTEM
EPIDEMIOLOGY OF NECK INJURIES ACCOMPANYING SPORT CONCUSSIONS IN YOUTH OVER A 13-YEAR PERIOD IN A COMMUNITY-BASED HEALTHCARE SYSTEM
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DOI：
10.26603/ijspt20190334
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发表时间：
2019-06-01
影响因子：
1.7
通讯作者：
Stevens-Lapsley, Jennifer
中科院分区：
文献类型：
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作者：
Carmichael, Joel P.;Staton, Elizabeth W.;Stevens-Lapsley, Jennifer
背景：引起脑震荡的相同外伤也可能引起颈部损伤。脑震荡和颈部损伤的症状相似，头颈复合体加速-减速损伤后的症状不能准确区分它们。关于运动性脑震荡青少年颈部损伤的流行病学研究很少。 目的：本研究的目的是按年龄、性别和运动项目，调查青少年非运动性脑震荡（Non-SRC）与运动性脑震荡（SRC）中诊断出颈部损伤的流行病学。研究设计：横断面流行病学研究方法：从社区电子健康记录中提取超过 13 年的去识别化数据进行分析分析非 SRC 和 5 至 21 岁青少年 SRC 的颈部损伤发生率和特征。按年龄和性别比较非 SRC 与 SRC，计算颈部损伤诊断患病率和比值比，以估计脑震荡青少年颈部损伤的风险。结果：提取了 16,085 条脑震荡记录，其中 5 至 21 岁青少年中 3,040 条 SRC 和 2,775 条非 SRC通过与所有 ICD-9 和 ICD-10 脑震荡代码交叉过滤与运动相关的关键字（例如，足球、篮球、足球、跑步、游泳、击球、骑马、滑雪等）来识别。 SRC 中诊断出的颈部损伤的患病率 (7.2%) 与非 SRC 中诊断出的颈部损伤的患病率 (12.1%, p < 0.000) 显着不同。颈部损伤诊断在女性总体中 (p < 0.000) 和非 SRC 中 (p < 0.000) 明显更为普遍。患有 SRC 的女性脑震荡的颈部损伤诊断患病率并不显着高于患有脑震荡的男性 (p = 0.164)。在 5 至 21 岁遭受脑震荡的青少年中，非 SRC 比 SRC 更有可能伴有颈部损伤诊断 (OR 1.66; 95% CI 1.39 至 1.98; p < 0.000)。同样，与 SRC 相比，非 SRC 中女性与男性颈部损伤的比例显着较高（IPR 1.90，95% CI 1.60 至 2.25，p < 0.000）。脑震荡发生率最高的运动与男女中脑震荡相关颈部损伤发生率最高的运动不同。结论：与 SRC 相比，非 SRC 中青年诊断颈部损伤的总体患病率较高SRC（12.1 vs. 7.2%，p < 0.001），无论男女，14 岁时患病率最高。与男性相比，女性诊断出伴有脑震荡的颈部损伤的风险显着较高（差异为 6.1%；p < 0.000）。
Background: The same trauma that produces concussion may also produce neck injury. The signs of concussion and neck injury are similar, and symptoms after acceleration-deceleration trauma to the head-neck complex do not accurately discriminate between them. Research on the epidemiology of neck injury among sport-concussed youth is sparse.Purpose: The purpose of this study was to investigate the epidemiology of diagnosed neck injury in non-sport-related concussion (Non-SRC) versus sport-related concussion (SRC) in youth by age, sex, and sport.Study design: Cross-sectional epidemiologic studyMethods: De-identified data from community-based electronic health records over 13 years were extracted to analyze rates and characteristics of neck injuries among non-SRCs and SRCs in youth aged five to 21. Neck injury diagnosis prevalence rates and odds ratios were calculated to estimate risk of neck injury among concussed youth, comparing non-SRCs to SRCs by age and sex.Results: Sixteen thousand, eight hundred eighty-five concussion records were extracted, of which 3,040 SRCs and 2,775 non-SRCs in youth aged five to 21 were identified by cross-filtering sport-related keywords (e.g., football, basketball, soccer, running, swimming, batting, horseback riding, skiing, etc.) with all ICD-9 and ICD-10 concussion codes. The prevalence of neck injuries diagnosed among SRCs (7.2%) was significantly different than the prevalence of neck injuries diagnosed among non-SRCs (12.1%, p < 0.000). Neck injury diagnoses were significantly more prevalent in females overall (p < 0.000) and among non-SRCs (p < 0.000). The prevalence of neck injury diagnoses was not significantly higher in concussed females versus concussed males with SRC (p = 0.164).Among youth aged five to 21 exposed to concussions, non-SRCs were more likely to be accompanied by a neck injury diagnosis than SRCs (OR 1.66; 95% CI 1.39 to 1.98; p < 0.000). Similarly, female-to-male neck injury proportion ratios were significantly higher in females in non-SRCs compared to SRCs (IPR 1.90, 95% CI 1.60 to 2.25, p < 0.000).Sports with highest prevalence of concussion differ from sports with highest prevalence of concussion-related neck injury in both sexes.Conclusions: The overall prevalence of diagnosed neck injuries in youth was higher in non-SRCs compared to SRCs (12.1 vs. 7.2%, p < 0.001), with the highest prevalence at age 14 in both sexes. The risk of neck injury diagnosis accompanying concussion was significantly higher in females compared to males (6.1% difference; p < 0.000).