Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Concussion Management of New York, New York, New York, USA.
Orthop J Sports Med. 2016 Jan 27;4(1):2325967115622621. doi: 10.1177/2325967115622621. eCollection 2016 Jan.
In the United States alone, millions of athletes participate in sports with potential for head injury each year. Although poorly understood, possible long-term neurological consequences of repetitive sports-related concussions have received increased recognition and attention in recent years. A better understanding of the risk factors for concussion remains a public health priority. Despite the attention focused on mild traumatic brain injury (mTBI) in football, gaps remain in the understanding of the optimal methodology to determine concussion incidence and position-specific risk factors.
To calculate the rates of concussion in professional football players using established and novel metrics on a group and position-specific basis.
Case-control study; Level of evidence, 3.
Athletes from the 2012-2013 and 2013-2014 National Football League (NFL) seasons were included in this analysis of publicly available data. Concussion incidence rates were analyzed using established (athlete exposure [AE], game position [GP]) and novel (position play [PP]) metrics cumulatively, by game unit and position type (offensive skill players and linemen, defensive skill players and linemen), and by position.
In 480 games, there were 292 concussions, resulting in 0.61 concussions per game (95% CI, 0.54-0.68), 6.61 concussions per 1000 AEs (95% CI, 5.85-7.37), 1.38 concussions per 100 GPs (95% CI, 1.22-1.54), and 0.17 concussions per 1000 PPs (95% CI, 0.15-0.19). Depending on the method of calculation, the relative order of at-risk positions changed. In addition, using the PP metric, offensive skill players had a significantly greater rate of concussion than offensive linemen, defensive skill players, and defensive linemen (P < .05).
For this study period, concussion incidence by position and unit varied depending on which metric was used. Compared with AE and GP, the PP metric found that the relative risk of concussion for offensive skill players was significantly greater than other position types. The strengths and limitations of various concussion incidence metrics need further evaluation.
A better understanding of the relative risks of the different positions/units is needed to help athletes, team personnel, and medical staff make optimal player safety decisions and enhance rules and equipment.
仅在美国，每年就有数百万人参加可能导致头部受伤的体育运动。尽管人们对重复性运动相关脑震荡的潜在长期神经后果了解甚少，但近年来，人们对这些后果的认识和关注度有所提高。更好地了解脑震荡的风险因素仍然是公共卫生的重点。尽管人们关注足球中的轻度创伤性脑损伤（mTBI），但在确定脑震荡发生率和特定位置风险因素的最佳方法方面仍存在差距。
基于群体和特定位置的既定和新方法，计算职业足球运动员脑震荡的发生率。
病例对照研究；证据水平，3 级。
本分析使用了可公开获取的数据，纳入了 2012-2013 年和 2013-2014 年美国国家橄榄球联盟（NFL）赛季的运动员。使用既定的（运动员暴露[AE]、比赛位置[GP]）和新的（位置比赛[PP]）指标，按比赛单位和位置类型（进攻技术球员和线卫、防守技术球员和线卫）以及位置对脑震荡发生率进行分析。
在 480 场比赛中，有 292 例脑震荡，每场比赛发生 0.61 例脑震荡（95%CI，0.54-0.68），每 1000 次 AE 发生 6.61 例脑震荡（95%CI，5.85-7.37），每 100 次 GP 发生 1.38 例脑震荡（95%CI，1.22-1.54），每 1000 次 PP 发生 0.17 例脑震荡（95%CI，0.15-0.19）。根据计算方法的不同，高危位置的相对顺序发生了变化。此外，使用 PP 指标，进攻技术球员的脑震荡发生率明显高于进攻线卫、防守技术球员和防守线卫（P<.05）。
在本研究期间，根据使用的指标不同，位置和单位的脑震荡发生率有所不同。与 AE 和 GP 相比，PP 指标发现进攻技术球员脑震荡的相对风险明显大于其他位置类型。各种脑震荡发生率指标的优势和局限性需要进一步评估。
需要更好地了解不同位置/单位的相对风险，以帮助运动员、团队人员和医务人员做出最佳的球员安全决策，并增强规则和设备。
