Statement of Purpose To investigate post-injury outcomes following non-sport related concussion in collegiate athletes and cadets.
Methods/Approach Participants were recruited across 30 colleges and universities as part of the National Collegiate Athletic Association-Department of Defense Concussion Assessment, Research, and Education (CARE) Consortium. Following a diagnosed concussion, participants were evaluated within 24–48 hours and at return-to-play (RTP). Primary outcomes at 24–48 hours included immediate injury reporting (yes/no) and symptom severity. Primary outcomes at RTP included total days participants reported symptoms and time until unrestricted RTP. Chi-square analyses were used to determine the associations between mechanism (sport-related concussion (SRC) vs. non-SRC [occurring outside of competition, practice, or training]) and immediate injury reporting. Mann-Whitney U tests were used to assess group differences in symptom severity, total days symptomatic, and days lost to injury.
Results Five thousand two hundred and sixteen cadets and athletes were included in analysis (n=1152 non-SRC; age=20.0±1.4 years). A significantly higher prevalence of non-SRC (62.4%) were not reported immediately relative to SRC (48.1%) (p<0.001). Non-SRC reported with greater symptom severity (median symptoms=28 vs. 24; p<0.001), more days with concussion-related symptoms (median days=11 vs. 7; p<0.001), and more days lost to injury (median days=20 vs. 13; p<0.001).
Conclusion Collegiate athletes and cadets with non-SRC reported with worse post-injury outcomes relative to sport-related concussions. Our findings suggest that closer consideration may need to be made for patients with a non-SRC in order to improve injury management and prognosis.
Significance Non-SRC remain a largely understudied group of head injuries but have poor clinical outcomes following injury. This may be due to lack of immediate care or higher variability in injury biomechanics associated with non-sport related mechanisms. It is critical to continue examining these injuries to better inform clinical management and implement prevention strategies aimed at reducing concussion occurring outside of sport.
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