College athletes experience worse post-injury outcomes for concussions suffered outside of sports

 Researchers from Children's Hospital of Philadelphia (CHOP) found that college athletes had worse post-injury outcomes related to concussions they experienced outside of sports than those they experienced while playing sports. Additionally, female athletes who sustained their injury outside of sports had more severe symptoms and more days in sports lost to injury relative to male athletes. These findings suggest the need for improved concussion recognition, reporting, and monitoring outside of sports.

The study was recently published online by the Journal of Athletic Training.

Concussions have the potential to impact the daily function and quality of life of those who sustain them. Prompt recognition of symptoms and early access to care can help minimize those effects. Most concussion research has primarily focused on injuries that occur while playing sports, but those studies often exclude concussions that can happen outside of sports, usually the result of falls or car crashes. Some research has indicated that patients with non-sports-related concussions have worse outcomes, but research into those effects in college-age patients is very limited.

"Patients who experience a concussion outside of sports may lack the resources that athletes who sustain their injury on the field have for concussion care, like immediate access to health care providers such as athletic trainers," said study first author Patricia Roby, PhD, an injury scientist who conducted this research while she was a postdoctoral fellow at CHOP.

To help address this gap in knowledge, researchers analyzed data from the National Collegiate Athletic Association-Department of Defense Concussion Assessment, Research, and Education (CARE) Consortium. A total of 3,500 college athletes were included in the study, including 555 that experienced a non-sports-related concussion. More than 40% of athletes included were female so that potential differences in recovery between males and females could be explored.

The study found that athletes who experienced non-sports-related concussions were less likely to report their injuries immediately, potentially due to lack of recognition of symptoms outside of the sport setting or hesitation to report the injury caused by unusual or careless mechanisms. Athletes who sustained non-sports-related concussions reported greater severity of their symptoms, more days with symptoms, and more days in sports lost to injury relative to patients who experienced sports-related concussions, and these findings were even more true in female patients compared with male patients.

"Our findings show that non-sports mechanisms of injury for concussion are an important consideration in college age young adults, something we had already described in our research in younger children. There is an opportunity to improve clinical outcomes by increasing awareness and education around concussions that happen outside of sports and reducing healthcare reporting barriers in this older age group as well," said senior study author Christina L. Master, MD, clinical director of the Minds Matter Concussion Program at CHOP. "Additionally, our findings related to sex differences in the trajectory of these injuries warrant additional investigation to see the extent to which reporting behaviors and access to medical teams are contributing to this disparity in outcomes."

This study was supported by the National Institute of Neurologic Disorders and Stroke of the National Institutes of Health grants R01NS097549 and T32NS043126 and the Grand Alliance Concussion Assessment, Research, and Education (CARE) Consortium, funded, in part by the National Collegiate Athletic Association (NCAA) and the Department of Defense (DOD). This work was also supported by the Office of the Assistant Secretary of Defense for Health Affairs, through the Combat Casualty Care Research Program, endorsed by the Department of Defense, through the Joint Program Committee 6/ Combat Casualty Care Research Program -- Psychological Health and Traumatic Brain Injury Program under Award No. W81XWH1420151.