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Epidemiological analysis of concussions in youth ice hockey players: A national emergency department database study - 20/04/23

Doi : 10.1016/j.ajem.2023.02.023 
Varag Abed, BS a , Gregory S. Hawk, PhD b , Roy Akarakian, MD c , Austin V. Stone, MD PhD a,
a Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, United States of America 
b Department of Statistics, University of Kentucky, United States of America 
c Department of Emergency Medicine, Keck School of Medicine of USC, United States of America 

Corresponding author at: Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, 2195 Harrodsburg Rd, Lexington, KY 40504, United States of America.Department of Orthopaedic Surgery and Sports MedicineUniversity of Kentucky2195 Harrodsburg RdLexingtonKY40504United States of America

Abstract

Purpose

To evaluate the epidemiology of concussions in youth ice hockey players.

Methods

The National Electronic Injury Surveillance System (NEISS) database was used to gather data. Concussions occurring during ice hockey participation in youth patients (4–21 years old) from 2012 to 2021 was gathered. Concussion mechanisms were grouped into 7 categories: head-to-player, head-to-puck, head-to-ice, head-to-board/glass, head-to-stick, head-to-goal post, and unknown. Hospitalization rates were also tabulated. Linear regression models were used to assess changes in yearly concussion and hospitalization rates over the study period. Results from these models were reported using parameter estimates [with 95% confidence intervals (CI)] and the estimated Pearson correlation coefficient. Additionally, logistic regression was used to model the risk of hospitalization across the different cause categories.

Results

A total of 819 ice hockey related concussions were analyzed between 2012 and 2021. The average age of our cohort was 13.4 years, with 89.3% (n = 731) of concussions occurring in males. The incidence of head-to-ice, head-to-board/glass, head-to-player, and head-to-puck concussion mechanisms decreased significantly over the study period (slope estimate = −2.1 concussions/year [CI: (−3.9, −0.2)], r = −0.675, p = 0.032), (slope estimate = −2.7 concussions/year [CI: (−4.3, −1.2)], r = −0.816, p = 0.004), (slope estimate = −2.2 concussions/year [CI: (−3.4, −1.0)], r = −0.832, p = 0.003), and (slope estimate = −0.4 concussions/year [CI: (−0.62, −0.09)], r = −0.768, p = 0.016), respectively. Majority of patients were discharged from the emergency department (ED) to their home, as only 20 people (2.4%) were hospitalized over our study period. The majority of concussions were due to head-to-ice (n = 285, 34.8%), followed by head-to-board/glass (n = 217, 26.5%) and head-to-player (n = 207, 25.3%). The most common cause for hospitalizations due to concussions was head-to-board/glass (n = 7, 35%), followed by head-to-player (n = 6, 30%) and head-to-ice (n = 5, 25%).

Conclusion

The most common mechanism of youth ice hockey concussions was head-to-ice in our 10-year study period, while head-to-board/glass was the most common cause of hospitalizations.

IRB

This project did not require review by the institutional review board.

Le texte complet de cet article est disponible en PDF.

Keywords : Ice hockey, Concussions, Youth, Epidemiology


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Vol 67

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