Cumulative effects associated with recurrent concussion in collegiate football players - The NCAA Concussion Study
Cumulative effects associated with recurrent concussion in collegiate football players - The NCAA Concussion Study
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DOI：
10.1001/jama.290.19.2549
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发表时间：
2003-11-19
影响因子：
120.7
通讯作者：
Kelly, JP
中科院分区：
文献类型：
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作者：
Guskiewicz, KM;McCrea, M;Kelly, JP
背景在美国每年大约发生300000例与运动有关的脑震荡，并且随着反复的头部损伤，严重后遗症的可能性可能增加。目的评估大学橄榄球运动员脑震荡的发生率和脑震荡后的恢复时间。和参与者来自美国25所大学的2905名足球运动员的前瞻性队列研究在1999年，2000年，及2001年进行了多项措施，并进行了前瞻性的跟进，以确定是否发生脑震荡。对脑震荡受伤的运动员进行监测，直到他们的脑震荡症状消失，并对重复脑震荡进行随访，直到他们的大学足球生涯结束或直到2001年足球赛季结束。结果在随访期间，运动员脑震荡的症状类型和持续时间以及恢复过程。在4251个赛季中，184名球员（6.3%）有脑震荡，其中12名球员（6.5%）在同一个赛季中重复脑震荡。报告的先前脑震荡次数与脑震荡事件的可能性之间存在关联。报告有3次或3次以上脑震荡史的球员发生脑震荡的可能性是没有脑震荡史的球员的3.0倍（95%置信区间，1.6-5.6）。头痛是受伤时最常报告的症状（85.2%），平均总体症状持续时间为82小时。恢复缓慢与多次脑震荡病史有关（30.0%有≥ 3次脑震荡病史的患者症状持续时间>1周，而14.6%有1次脑震荡病史的患者症状持续时间>1周）。在12起赛季内重复脑震荡事件中，91.7%发生在首次损伤后10天内，9（75.0%）发生在首次损伤后7天内。结论我们的研究表明，有既往脑震荡史的运动员比无既往脑震荡史的运动员更容易发生脑震荡损伤; 1/15的脑震荡球员可能在同一个赛季中有额外的脑震荡;以前的脑震荡可能与神经功能恢复较慢有关。
Context Approximately 300000 sport-related concussions occur annually in the United States, and the likelihood of serious sequelae may increase with repeated head injury.Objective To estimate the incidence of concussion and time to recovery after concussion in collegiate football players.Design, Setting, and Participants Prospective cohort study of 2905 football players from 25 US colleges were tested at preseason baseline in 1999, 2000, and 2001 on a variety of measures and followed up prospectively to ascertain concussion occurrence. Players injured with a concussion were monitored until their concussion symptoms resolved and were followed up for repeat concussions until completion of their collegiate football career or until the end of the 2001 football season.Main Outcome Measures Incidence of concussion and repeat concusion; type and duration of symptoms and course of recovery among players who were injured with a concussion during the seasons.Results During follow-up of 4251 player-seasons, 184 players (6.3%) had a concussion, and 12 (6.5%) of these players had a repeat concussion within the same season. There was an association between reported number of previous concussions and likelihood of incident concussion. Players reporting a history of 3 or more previous concussions were 3.0 (95% confidence interval, 1.6-5.6) times more likely to have an incident concussion than players with no concussion history. Headache was the most commonly reported symptom at the time of injury (85.2%), and mean overall symptom duration was 82 hours. Slowed recovery was associated with a history of multiple previous concussions (30.0% of those with greater than or equal to3 previous concussions had symptoms lasting >1 week compared with 14.6% of those with 1 previous concussion). Of the 12 incident within-season repeat concussions, 11 (91.7%) occurred within 10 days of the first injury, and 9 (75.0%) occurred within 7 days of the first injury.Conclusions Our study suggests that players with a history of previous concussions are more likely to have future concussive injuries than those with no history; 1 in 15 players With a concussion may have additional concussions in the same playing season; and previous concussions may be associated with slower recovery of neurological function.