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New and Recurrent Concussions in High-School Athletes Before and After Traumatic Brain Injury Laws, 2005-2016
Jingzhen Yang1, R Dawn Comstock1, Honggang Yi1
1Jingzhen Yang is with the Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, and Department of Pediatrics, College of Medicine and Department of Epidemiology, College of Public Health, The Ohio State University, Columbus. R. Dawn Comstock is with the Department of Epidemiology, The Colorado School of Public Health, and the Department of Pediatrics, Emergency Medicine, School of Medicine, University of Colorado Anschutz, Aurora. Honggang Yi is with the Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, and the Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province, China. Hosea H. Harvey is with the Beasley School of Law, Temple University, Philadelphia, PA. Pengcheng Xun is with the Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington.
Youth sports laws increased reporting of new and recurrent concussions in high-school athletes. While initial rates rose, recurrent concussion rates significantly declined over time, suggesting improved injury management.
Area of Science:
- Sports Medicine
- Public Health
- Neurology
Background:
- Traumatic brain injuries (TBIs) in young athletes are a significant concern.
- Youth sports legislation aims to mitigate TBI risks.
- Understanding concussion trends pre- and post-legislation is crucial for evaluating effectiveness.
Purpose of the Study:
- To analyze trends in new and recurrent sports-related concussions among high-school athletes.
- To compare concussion rates before and after the implementation of youth sports TBI laws.
Main Methods:
- Utilized an interrupted time-series design analyzing concussion data from 2005-2016 (High School Reporting Injury Online).
- Examined concussion rates across pre-law, immediate post-law, and post-law periods for 9 sports.
- Employed general linear models to assess trends in new and recurrent concussion rates per 100,000 athlete exposures.
Main Results:
- A total of 8043 concussions were reported (88.7% new, 11.3% recurrent).
- Observed a significant upward trend in both new and recurrent concussion reports from pre-law through post-law periods.
- A notable decline in recurrent concussion rates emerged 2.6 years after law implementation; football showed distinct trends.
Conclusions:
- Increased concussion identification and reporting likely contribute to observed rate increases.
- The long-term impact of TBI laws requires further investigation.
- Recurrent concussion rates may decrease with sustained implementation of TBI legislation.
