Development of a risk prediction model among professional hockey players with visible signs of concussion
Development of a risk prediction model among professional hockey players with visible signs of concussion
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DOI：
10.1136/bjsports-2016-097091
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发表时间：
2018-09-01
影响因子：
18.4
通讯作者：
Comper, Paul
中科院分区：
文献类型：
--
作者：
Bruce, Jared M.;Echemendia, Ruben J.;Comper, Paul
很少有研究探讨如何最好地识别脑震荡运动员。本研究的目的是开发一个初步的风险决策模型，使用可见的迹象（VS）和损伤机制（MOI），以预测随后的脑震荡diagnosis.Methods的可能性编码器查看和记录VS和相关的MOI的所有NHL比赛在2013-2014和2014-2015常规赛的过程中。编码完成后，从NHL损伤监测系统中识别出运动员脑震荡，并确定表现出VS的运动员是否随后被俱乐部医务人员诊断为脑震荡，作为编码事件的结果。最初被另一名运动员的肩膀击中，以及在冰上被第二次击中，都与随后被诊断为脑震荡的风险增加有关。相比之下，最初用棍子击打与随后脑震荡诊断的风险降低有关。使用上述VS和MOI的组合的风险预测模型是上级的方法，依赖于个人VS和相关的MOI（敏感性= 81%，特异性= 72%，阳性预测值=26%）。结论VS和MOI的结合使用显着提高了临床医生的能力，以确定球员谁需要进行评估可能的脑震荡。根据这些数据，已编制出初步的冲击预测测井。等待前瞻性验证，使用这些方法可能会改善早期脑震荡的检测和评估。
Background Little research examines how to best identify concussed athletes. The purpose of the present study was to develop a preliminary risk decision model that uses visible signs (VS) and mechanisms of injury (MOI) to predict the likelihood of subsequent concussion diagnosis.Methods Coders viewed and documented VS and associated MOI for all NHL games over the course of the 2013-2014 and 2014-2015 regular seasons. After coding was completed, player concussions were identified from the NHL injury surveillance system and it was determined whether players exhibiting VS were subsequently diagnosed with concussions by club medical staff as a result of the coded event.Results Among athletes exhibiting VS, suspected loss of consciousness, motor incoordination or balance problems, being in a fight, having an initial hit from another player's shoulder and having a secondary hit on the ice were all associated with increased risk of subsequent concussion diagnosis. In contrast, having an initial hit with a stick was associated with decreased risk of subsequent concussion diagnosis. A risk prediction model using a combination of the above VS and MOI was superior to approaches that relied on individual VS and associated MOI (sensitivity=81%, specificity=72%, positive predictive value=26%).Conclusions Combined use of VS and MOI significantly improves a clinician's ability to identify players who need to be evaluated for possible concussion. A preliminary concussion prediction log has been developed from these data. Pending prospective validation, the use of these methods may improve early concussion detection and evaluation.