Research Reports - Trends in sports-related concussion diagnoses in the USA

Phys Sportsmed. 2017 Sep;45(3):239-244. doi: 10.1080/00913847.2017.1327304. Epub
2017 May 17.

Amoo-Achampong K(1), Rosas S(2), Schmoke N(3), Accilien YD(3), Nwachukwu BU(4),
McCormick F(5).

OBJECTIVE: To describe recent epidemiological trends in concussion diagnosis
within the United States (US) population.
METHODS: We conducted a retrospective review of PearlDiver, a private-payor
insurance database. Our search included International Classification of Disease,
Ninth Revision codes for sports-related concussions spanning 2010 through 2014.
Overall study population included patients aged 5 to 39 with subgroup analysis
performed on Cohort A (Youth), children and adolescents aged 5 to 19, and Cohort
B (Adults), adults aged 20 to 39. Incidence was defined as the number of
individuals diagnosed normalized to the number of patients in the database for
each demographic.
RESULTS: Our search returned 1,599 patients diagnosed during the study period.
The average (±SD) annual rate was 4.14 ± 1.42 per 100,000 patients for the
overall population. Youth patients were diagnosed at a mean annual rate of
3.78 ± 1.30 versus 0.36 ± 0.16 per 100,000 in Adults. Concussion normalized
incidence significantly increased from 2.47 to 3.87 per 100,000 patients (57%) in
the Youth cohort (p = 0.048). In Adults, rate grew from 0.34 to 0.44 per 100,000
patients (29%) but was not statistically significant (p = 0.077). Four-year
compound annual growth rates for Youth and Adults were 26.3% and 20.4%,
respectively. Youth patients comprised 1,422/1,599 (90.18%) of all concussion
diagnoses and were predominantly male (75%). Adults also constituted 138/1,599
(8.63%) of the sample and were also largely male (80%). Midwestern states had
highest diagnostic rates (Cohort A:19 per 100,000 and Cohort B:1.8 per 100,000).
Both cohorts had the most total diagnoses made in the fourth quarter followed by
the second quarter.
CONCLUSION: Sports-related concussion diagnostic rates have grown significantly
in the youth population. Quarterly, regional and gender distributions appear
consistent with participation in concussion-prone sports. Utilization of
individualized and multifaceted approaches are recommended to advance diagnosis,
assessment and management of concussions in the U.S. 

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