Risk Factors Associated with Sustaining a Sport-related Concussion: An Initial Synthesis Study of 12,320 Student-Athletes

Abstract

Objective: The empirical identification of risk factors associated with sport-related concussion (SRC) may improve the management of student-athletes. The current study attempted to identify and quantify bio-cognitive risk factors associated with sustaining a SRC. Methods: Cross-sectional ambispective study; level of evidence, 3. Neurocognitive testing of 12,320 middle school, high school and collegiate athletes was completed at preseason baseline and post-SRC. Univariate and multivariable logistic regressions were used to determine which pre-injury variables accurately predicted the occurrence of SRC. A quantitative risk score for each variable was developed. Results: Five of 13 variables maintained significance in the multivariable model with the associated weighted point scores: SRC history (21), prior headache treatment (6), contact sport (5), youth level of play (7), and history of ADHD/LD (2). Six stratified groups were formed based on probability of SRC, which produced an area under the curve (AUC) of 0.71 (95% CI 0.69-0.72, p