Joel P Carmichael1, Elizabeth W Staton2, Patrick J Blatchford3, Jennifer Stevens-Lapsley. 1. Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA. 2. Department of Family Medicine, University of Colorado, Aurora, CO, USA. 3. Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Abstract
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 study. METHODS: 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).
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 study. METHODS: 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).
Authors: Ryan T Tierney; Michael R Sitler; C Buz Swanik; Kathleen A Swanik; Michael Higgins; Joseph Torg Journal: Med Sci Sports Exerc Date: 2005-02 Impact factor: 5.411
Authors: P McCrory; K Johnston; W Meeuwisse; M Aubry; R Cantu; J Dvorak; T Graf-Baumann; J Kelly; M Lovell; P Schamasch Journal: Br J Sports Med Date: 2005-04 Impact factor: 13.800
Authors: Scott R Darling; John J Leddy; John G Baker; Amy J Williams; Anthony Surace; Jeffrey C Miecznikowski; Barry Willer Journal: Clin J Sport Med Date: 2014-03 Impact factor: 3.638
Authors: Christy L Collins; Erica N Fletcher; Sarah K Fields; Lisa Kluchurosky; Mary Kay Rohrkemper; R Dawn Comstock; Robert C Cantu Journal: J Prim Prev Date: 2014-10
Authors: John J Leddy; John G Baker; Asim Merchant; John Picano; Daniel Gaile; Jason Matuszak; Barry Willer Journal: Clin J Sport Med Date: 2015-05 Impact factor: 3.638
Authors: Gustavo Saposnik; Donald Redelmeier; Christian C Ruff; Philippe N Tobler Journal: BMC Med Inform Decis Mak Date: 2016-11-03 Impact factor: 2.796