Strategic Clinical Network-Health Technology Assessment and Adoption, Research Innovation and Analytics Portfolio, Alberta Health Services, Calgary, Alberta, Canada.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Br J Sports Med. 2016 Mar;50(5):292-7. doi: 10.1136/bjsports-2015-094978. Epub 2015 Nov 30.
To conduct a comprehensive systematic review and meta-analysis of studies assessing the incidence of concussion in youth athletes. Specifically, we estimate the overall risk of concussion in youth sports and compare sport-specific estimates of concussion risk.
Systemic review and meta-analysis.
A search of Medline, Embase (1980 through September 2014), and SportDiscus (1985 through September 2014) supplemented by manual searches of bibliographies and conference proceedings.
We included studies if they met the inclusion criteria of study design (prospective cohort study), relevant sports identified from the literature (eg, American football, rugby, hockey, lacrosse, soccer/football, basketball, baseball, softball, wrestling, field hockey, track, taekwondo, volleyball and cheerleading), population (males and females ≤18 years old), and outcome (concussion).
Of the 698 studies reviewed for eligibility, 23 articles were accepted for systematic review and 13 of which were included in a meta-analysis. Random effects models were used to pool overall and sport-specific concussion incidence rates per 1000 athlete exposures (AEs). The overall risk of concussion was estimated at 0.23 (95% CI 0.19 to 0.28). The three sports with the highest incidence rates were rugby, hockey and American football at 4.18, 1.20 and 0.53, respectively. Lowest incidence rates per 1000 AEs occurred in volleyball, baseball and cheerleading at 0.03, 0.06 and 0.07, respectively. Quality of the included studies varied, with the majority of studies not reporting age and gender-specific incidence rates or an operational definition for concussion.
There are striking differences in the rates of incident youth concussion across 12 sports. This systematic review and meta-analysis can serve as the current sport-specific baseline risk of concussion among youth athletes.
对评估青少年运动员脑震荡发生率的研究进行全面的系统回顾和荟萃分析。具体而言，我们评估了青少年运动中脑震荡的总体风险，并比较了特定运动的脑震荡风险估计值。
系统性回顾和荟萃分析。
对 Medline、Embase（1980 年至 2014 年 9 月）和 SportDiscus（1985 年至 2014 年 9 月）的检索，辅以对参考文献和会议记录的手工检索。
如果研究符合纳入标准（前瞻性队列研究）、文献中确定的相关运动（例如美式橄榄球、橄榄球、曲棍球、长曲棍球、足球/橄榄球、篮球、棒球、垒球、摔跤、田径、跆拳道、排球和啦啦队）、人群（≤18 岁的男性和女性）和结局（脑震荡），则纳入研究。
在审查的 698 项研究中，有 23 项被接受进行系统评价，其中 13 项被纳入荟萃分析。使用随机效应模型汇总了每 1000 名运动员暴露（AE）的总体和特定运动的脑震荡发生率。脑震荡的总体风险估计为 0.23（95% CI 0.19 至 0.28）。发病率最高的三项运动分别是橄榄球、曲棍球和美式橄榄球，分别为 4.18、1.20 和 0.53。每 1000 次 AE 发生率最低的三项运动是排球、棒球和啦啦队，分别为 0.03、0.06 和 0.07。纳入研究的质量差异很大，大多数研究没有报告年龄和性别特异性的发病率或脑震荡的操作定义。
12 项运动中青少年脑震荡的发生率存在显著差异。本系统评价和荟萃分析可作为目前青少年运动员脑震荡的特定运动基础风险。
