In the JournalsPerspective

Pediatric concussion rates 5% higher than reported by EDs

Phillip T. Veliz, PhD
Philip T. Veliz

Concussions are prevalent among teenagers in the United States, with 19.5% of adolescents diagnosed with at least one incident and 5.5% diagnosed with more than one incident, according to a research letter published in JAMA.

According to the researchers, this rate is approximately 4% to 5% higher than what is reported by emergency departments in the U.S.

“Little is known about the prevalence and correlates of concussions among U.S.  adolescents,” Philip T. Veliz, PhD, from the Institute for Research on Women and Gender at the University of Michigan, and colleagues wrote. “A regional study of Canadian adolescents found that approximately 20% had sustained a concussion. Providing a national baseline of concussion prevalence and correlates is necessary to target and monitor prevention efforts to reduce these types of injuries during this important developmental period.”

In a survey of more than 13,000 teenagers, nearly 20% noted at least one diagnosed concussion during their lifetime.
Source: Shutterstock.com

To determine the baseline prevalence of concussions among U.S. adolescents, the researchers collected cross-sectional data from the Monitoring the Future survey. This survey included teens in grades 8, 10 and 12. Concussion rates were assessed through an item created to do so by concussion experts and was added to the survey in 2016.

Those who took the survey answered questions concerning if they had been diagnosed with a concussion and the number of times they had been diagnosed (“no,” “yes, once,” “yes, more than once”). The researchers also collected sociodemographic information, including sex, race/ethnicity, grade level and participation in a competitive sport within the past year. The survey included 21 different sports, which encompassed contact, semicontact, noncontact and other sports.

Of the 13,088 teenagers who responded to the survey, 50.2% were female and 46.8% were white, with a modal age of 16 (range, 12-18). Approximately 19.5% of the respondents had been diagnosed with at least one concussion (95% CI, 18.5%-20.6%). Nearly 14% of this cohort were diagnosed with one concussion (9% CI, 13.1%-14.8%), and 5.5% sustained more than one concussion (95% CI, 4.9%-6.1%).

Boys in a higher grade level who participated in competitive sports, especially contact sports, were most likely to sustain more than one concussion in their lifetime (11.1%; adjusted OR, 4.83 [95% CI, 3.29-4.83]).

“The prevalence of concussions among adolescents reported here is much higher than [that] reported from emergency departments — ie, between 4% and 5% — but consistent with regional surveys — ie, 20%,” Veliz and colleagues wrote. “Greater effort to track concussions using large-scale epidemiological data are needed to identify high-risk subpopulations and monitor prevention efforts.” – by Katherine Bortz

Disclosure: The researchers report no relevant financial disclosures.

Phillip T. Veliz, PhD
Philip T. Veliz

Concussions are prevalent among teenagers in the United States, with 19.5% of adolescents diagnosed with at least one incident and 5.5% diagnosed with more than one incident, according to a research letter published in JAMA.

According to the researchers, this rate is approximately 4% to 5% higher than what is reported by emergency departments in the U.S.

“Little is known about the prevalence and correlates of concussions among U.S.  adolescents,” Philip T. Veliz, PhD, from the Institute for Research on Women and Gender at the University of Michigan, and colleagues wrote. “A regional study of Canadian adolescents found that approximately 20% had sustained a concussion. Providing a national baseline of concussion prevalence and correlates is necessary to target and monitor prevention efforts to reduce these types of injuries during this important developmental period.”

In a survey of more than 13,000 teenagers, nearly 20% noted at least one diagnosed concussion during their lifetime.
Source: Shutterstock.com

To determine the baseline prevalence of concussions among U.S. adolescents, the researchers collected cross-sectional data from the Monitoring the Future survey. This survey included teens in grades 8, 10 and 12. Concussion rates were assessed through an item created to do so by concussion experts and was added to the survey in 2016.

Those who took the survey answered questions concerning if they had been diagnosed with a concussion and the number of times they had been diagnosed (“no,” “yes, once,” “yes, more than once”). The researchers also collected sociodemographic information, including sex, race/ethnicity, grade level and participation in a competitive sport within the past year. The survey included 21 different sports, which encompassed contact, semicontact, noncontact and other sports.

Of the 13,088 teenagers who responded to the survey, 50.2% were female and 46.8% were white, with a modal age of 16 (range, 12-18). Approximately 19.5% of the respondents had been diagnosed with at least one concussion (95% CI, 18.5%-20.6%). Nearly 14% of this cohort were diagnosed with one concussion (9% CI, 13.1%-14.8%), and 5.5% sustained more than one concussion (95% CI, 4.9%-6.1%).

Boys in a higher grade level who participated in competitive sports, especially contact sports, were most likely to sustain more than one concussion in their lifetime (11.1%; adjusted OR, 4.83 [95% CI, 3.29-4.83]).

“The prevalence of concussions among adolescents reported here is much higher than [that] reported from emergency departments — ie, between 4% and 5% — but consistent with regional surveys — ie, 20%,” Veliz and colleagues wrote. “Greater effort to track concussions using large-scale epidemiological data are needed to identify high-risk subpopulations and monitor prevention efforts.” – by Katherine Bortz

Disclosure: The researchers report no relevant financial disclosures.

    Perspective

    This JAMA article examined the prevalence of concussion among adolescents in the United States. Not surprisingly, in 2016, almost 20% of U.S. adolescents in grades 9, 10, and 12 reported at least one diagnosed concussion in their lifetime, while 5% reported being diagnosed with more than one concussion; involvement in competitive sports with contact increased the odds of concussion.

    Of course, the self-reporting measure and increased awareness of concussion may in part be related to this increased frequency, but awareness of the importance of preventing athletes from returning to their sport after a perceived concussion is vitally important now. In fact, this may be one of the most effective measures of preventing brain trauma as identifying a potential concussion early and allowing the athlete to heal or perhaps not engage in the activity again can be very important. Several factors were associated with prevalence in reporting a diagnosed concussion: Being male, white, in a higher grade, and participating in competitive sports.

    The number in this study is very similar to the Canadian prevalence also, which was approximately 20%. Again, being aware of how frequent this condition can be in adolescents is vitally important for caregivers, coaches, family, and athletes themselves to monitor and take appropriate care when it occurs.

    • Alan G. Shepard, MD
    • General neurologist Clinical associate professor of neurology Northwestern University Feinberg School of Medicine

    Disclosures: Shepard reports no relevant financial disclosures.