Sports Concussion Clinic, Division of Sports Medicine, Children's Hospital Boston, 319 Longwood Avenue, Boston, MA 02115, USA.
Am J Sports Med. 2011 Nov;39(11):2304-10. doi: 10.1177/0363546511423503. Epub 2011 Oct 3.
Little existing data describe which medical professionals and which medical studies are used to assess sport-related concussions in high school athletes.
To describe the medical providers and medical studies used when assessing sport-related concussions. To determine the effects of medical provider type on timing of return to play, frequency of imaging, and frequency of neuropsychological testing.
Descriptive epidemiology study.
All concussions recorded by the High School Reporting Information Online (HS RIO) injury surveillance system during the 2009 to 2010 academic year were included. χ(2) analyses were conducted for categorical variables. Fisher exact test was used for nonparametric data. Logistic regression analyses were used when adjusting for potential confounders. Statistical significance was considered for P < .05.
The HS RIO recorded 1056 sport-related concussions, representing 14.6% of all injuries. Most (94.4%) concussions were assessed by athletic trainers (ATs), 58.8% by a primary care physician. Few concussions were managed by specialists. The assessment of 21.2% included computed tomography. Computerized neuropsychological testing was used for 41.2%. For 50.1%, a physician decided when to return the athlete to play; for 46.2%, the decision was made by an AT. After adjusting for potential confounders, no associations between timing of return to play and the type of provider (physician vs AT) deciding to return the athlete to play were found.
Concussions account for nearly 15% of all sport-related injuries in high school athletes. The timing of return to play after a sport-related concussion is similar regardless of whether the decision to return the athlete to play is made by a physician or an AT. When a medical doctor is involved, most concussions are assessed by primary care physicians as opposed to subspecialists. Computed tomography is obtained during the assessment of 1 of every 5 concussions occurring in high school athletes.
现有的数据很少描述哪些医疗专业人员和哪些医学研究用于评估高中生运动员的运动相关性脑震荡。
描述评估运动相关性脑震荡时使用的医疗提供者和医学研究。确定医疗提供者类型对重返赛场时间、影像学检查频率和神经心理学测试频率的影响。
描述性流行病学研究。
所有在 2009 至 2010 学年通过高中报告信息在线（HS RIO）伤害监测系统记录的脑震荡均被纳入研究。对于分类变量进行卡方分析。非参数数据使用 Fisher 精确检验。当调整潜在混杂因素时，使用逻辑回归分析。P 值<0.05 时认为有统计学意义。
HS RIO 记录了 1056 例运动相关性脑震荡，占所有伤害的 14.6%。大多数（94.4%）脑震荡由运动训练员（AT）评估，58.8%由初级保健医生评估。很少有脑震荡由专家管理。21.2%的脑震荡评估包括计算机断层扫描。41.2%使用计算机化神经心理学测试。50.1%的情况下，由医生决定运动员何时重返赛场；46.2%的情况下，由 AT 决定。在调整潜在混杂因素后，发现返回赛场的时间与决定让运动员重返赛场的提供者类型（医生与 AT）之间没有关联。
脑震荡占高中运动员所有运动相关性伤害的近 15%。运动相关性脑震荡后重返赛场的时间与决定让运动员重返赛场的是医生还是 AT 无关。当涉及到医生时，大多数脑震荡由初级保健医生评估，而不是由亚专科医生评估。在高中运动员发生的每 5 例脑震荡中，有 1 例在评估时会进行计算机断层扫描。
