Concussion: Mechanisms of Injury and Trends from 1997 to 2019

There is limited long-term epidemiological data focused on concussions in the United States.

The National Electronic Injury Surveillance System was queried from 1997 to 2019 for concussion diagnoses. National incidence rates, stratified by age and sex, were estimated. Injury mechanisms were ranked.

From 1997 to 2019, there was a 3-fold increase in the diagnosis of concussion from 82,103 (95% CI 77,650-86,555) in 1997 to 261,722 (95% CI 212,156-311,288) in 2019 (p<0.001). Fall-related head-injury mechanisms were most common in very young (<5 year old) and older (>65 year old) patients. Sports-related injuries were most common in those age 5-24 years old.

It remains unclear if the observed two-decade rise in reported concussions represents a true increase in incidence or is indicative of improvements in early detection, diagnosis, and treatment during this time period. Common injury mechanisms described highlight the need for improved age-specific safety recommendations.