Incidence and Risk Factors for Concussions

Abstract

The incidence of concussions has continued to rise annually across all settings leading to a major cause of public concern. Age-related patterns have been identified and allow us to compare incidence and mechanism of injury between various populations. In the emergency department (ED), the most common mechanism of injury in younger individuals below the age of 15 and individuals older than the age of 65 includes mechanical falls followed by motor vehicle collisions and then assaults. ED visits for sports- and recreational-related TBI have seen significant increases in all age groups and genders, especially between the ages of 10 and 19 years old. A vast number of students participate in high school sports, making this the largest athletic cohort concluding the burden of concussions. Concussions in contact sports such as football, hockey, and soccer are more common when compared to non-contact sports. This is also seen on a smaller scale with collegiate- and professional-level athletes. Risk factors for mild traumatic brain injury (mTBI) include physical demands of training, contact play, repetitive stress, and history of prior concussion. A higher rate is seen in athletes during competition when compared to practice injuries. Females have higher rates in gender-comparable sports such as soccer. Similarly, military service members have a higher incidence of mTBI compared to civilians where military culture and blast injuries are contributing factors. Concussions are underreported; however, increased incidence may be attributed to early and more accurate diagnosis since the implementation of TBI laws.