Objective To investigate post-injury outcomes following non-sport related concussion (non-SRC) in collegiate athletes and cadets.

Design Descriptive epidemiology.

Setting 30 colleges/universities and military service academies in the Concussion Assessment, Research and Education (CARE) Consortium.

Participants 4,783 cadets and athletes (n=1036 non-SRC, n=3747 SRC) diagnosed with concussion.

Interventions Concussion mechanism (sport related (SRC) vs. non-SRC).

Outcome Measures Injury proportion ratios (IPR) compared the proportion of injuries by mechanism (SRC referent) for immediate reporting, longer recovery, mental status alterations, loss of consciousness (LOC), posttraumatic amnesia (PTA), retrograde amnesia (RGA), motor impairments, delayed symptom presentation, and requiring hospital transport. Mann-Whitney U tests were used to assess group differences in symptom severity within 48h of injury, total days symptomatic and days lost to injury.

Main Results A higher proportion of non-SRC were not reported immediately (IPR=1.27, 95%CI=1.21–1.33), had longer recovery (IPR=1.63 95%CI=1.53–1.74), reported altered mental status (IPR=1.09, 95%CI=1.03–1.14), LOC (IPR=2.77, 95%CI=2.33–3.29), PTA (IPR=1.4, 95%CI=1.24–1.78), RGA (IPR=1.49, 95%CI=1.24–1.78), motor impairment (IPR=1.17, 95%CI=1.06–1.29), and required hospital transport (IPR=3.99, 95%CI=3.44–4.62). Non-SRC reported with greater symptom severity (median=29 vs. 25; p<0.001), more days with concussion-related symptoms (median=10 vs. 7; p<0.0001), and more days lost to injury (median=20 vs. 13; p<0.0001).

Conclusions Collegiate athletes and cadets with non-SRC reported worse post-injury outcomes relative to SRC. This may be due to lack of immediate care or higher variability in injury biomechanics associated with non-SRC mechanisms. 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.