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3) Follow up Post-Injury Evaluation
3.28 Sex differences in non-sport related concussion: a care consortium study
  1. Patricia Roby1,
  2. Anne Mozel1,
  3. Kristy Arbogast1,2,
  4. Scott Anderson3,
  5. Thomas Buckley4,
  6. Jaclyn Caccese5,
  7. Sara Chrisman6,7,
  8. James Clugston8,
  9. James Eckner9,
  10. Carrie Esopenko10,
  11. Paul Pasquina11,
  12. Margot Putukian12,
  13. Steven Broglio9,
  14. Thomas McAllister13,
  15. Michael McCrea14,
  16. Christina Master1,2
  1. 1Children’s Hospital of Philadelphia, Philadelphia, USA
  2. 2University of Pennsylvania, Philadelphia, USA
  3. 3University of Oklahoma, Norman, USA
  4. 4University of Delaware, Newark, USA
  5. 5The Ohio State University, Columbus, USA
  6. 6Seattle Children’s Research Institute, Seattle, USA
  7. 7University of Washington, Seattle, USA
  8. 8University of Florida, Gainesville, USA
  9. 9University of Michigan, Ann Arbor, USA
  10. 10Mount Sinai Icahn School of Medicine, New York, USA
  11. 11Uniformed Services University of the Health Sciences, Bethesda, USA
  12. 12Princeton University, Princeton, USA
  13. 13Indiana University, Bloomington, USA
  14. 14Medical College of Wisconsin, Milwaukee, USA

Abstract

Objective To describe sex differences in non-sport related concussion (non-SRC).

Design Descriptive epidemiology.

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

Participants 1,036 cadets and athletes (n=555 females) with non-SRC (outside of competition/practice/training).

Interventions Sex.

Outcome Measures Injury proportion ratios (IPR) compared the proportion of injuries by sex (female referent) for diagnosing provider, longer recovery (≥14 days to asymptomatic and/or ≥24 days to return-to-play), mental status alterations, loss of consciousness (LOC), posttraumatic amnesia (PTA), retrograde amnesia (RGA), and hospital transport.

Main Results A higher proportion of females with non-SRC were diagnosed by athletic trainers (IPR=0.83, 5%CI=0.69–0.98) or team physicians (IPR=0.38, 95%CI=0.27–0.54), whereas a higher proportion of males were diagnosed by (IPR=1.31, 95%CI=1.13–1.53) primary care physicians. Non-SRC mechanism of being struck by an object (IPR=0.79, 95%CI=0.66–0.94) or motor vehicle crash (IPR=0.76, 95%CI=0.6–0.97) accounted for a larger proportion in females, whereas fight/assault/altercation accounted for a larger proportion in males (IPR=2.75, 95%CI=1.6–4.75). A higher proportion of males reported altered mental status (IPR=1.33, 95%CI=1.17–1.51), LOC (IPR=1.54, 95%CI=1.14–2.09), PTA (IPR=1.7, 95%CI=1.25–2.3), RGA (IPR=1.95, 95%CI=1.26–3.02), and hospital transport (IPR=1.34, 95%CI=1.08–1.65), whereas a larger proportion of females had longer recovery (IPR=0.80 95%CI=0.71–0.91).

Conclusions A greater proportion of males with a non-SRC reported to primary care physicians, had a fight/assault/altercation mechanism, and had altered mental status, LOC, PTA, RGA, and hospital transport, while a greater proportion of females reported to athletic trainers or team physicians, were struck by an object or in a motor vehicle crash, and had longer recovery.

https://doi.org/10.1136/bjsports-2023-concussion.244

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