Department of Neurosurgery, UCLA Steve Tisch BrainSPORT Program, University of California, Los Angeles.
Now with Department of Neurology, University of Washington Medical Center, Seattle.
JAMA Netw Open. 2020 Nov 2;3(11):e2025082. doi: 10.1001/jamanetworkopen.2020.25082.
Concussions are a common occurrence in young athletes. Hypobaric hypoxemia, such as that experienced during airplane travel, can potentially cause alterations to cerebral blood flow and increased neuroinflammatory response. It remains unknown whether flying early after a concussion may influence the clinical course of injury.
To determine whether there is an association between concussion recovery and airplane travel in collegiate athletes and military cadets.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study was conducted by the National Collegiate Athletic Association and US Department of Defense Concussion Assessment, Research, and Education Consortium from August 3, 2014, to September 13, 2018. Participant groups were categorized by those who flew within 72 hours of injury and those who did not fly. All participants included in the final analyses had complete data of interest and only 1 injury during the study. Data analysis was performed from September 2018 to March 2020.
Recovery outcome measures were defined as time (in days) from injury to return to activity, school, and baseline symptoms. Symptom and headache severity scores were derived from the Sports Concussion Assessment Tool-Third Edition. Scores for both groups were taken at baseline and a median of 2 days after injury.
A total of 92 participants who flew (mean [SD] age, 19.1 [1.2] years; 55 male [59.8%]) and 1383 participants who did not fly (mean [SD] age, 18.9 [1.3] years; 809 male [58.5%]) were included in the analysis of symptom recovery outcomes (analysis 1). Similarly, 100 participants who flew (mean [SD] age, 19.2 [1.2] years; 63 male [63.0%]) and 1577 participants who did not fly (mean [SD] age, 18.9 [1.3] years; 916 male [58.1%]) were included in the analysis of symptom severity outcomes (analysis 2). No significant group differences were found regarding recovery outcome measures. Likewise, there were no group differences in symptom (estimated mean difference, 0.029; 95% CI, -0.083 to 0.144; P = .67) or headache (estimated mean difference, -0.007; 95% CI, -0.094 to 0.081; P = .91) severity scores.
Airplane travel early after concussion was not associated with recovery or severity of concussion symptoms. These findings may help guide future recommendations on flight travel after concussion in athletes.
脑震荡在年轻运动员中很常见。例如在飞机旅行中经历的低气压低氧血症，可能会导致大脑血流改变和神经炎症反应增加。目前尚不清楚脑震荡后早期飞行是否会影响损伤的临床过程。
确定大学生运动员和军校学员的脑震荡恢复与飞机旅行之间是否存在关联。
设计、地点和参与者：这项队列研究由美国国家大学生体育协会和美国国防部脑震荡评估、研究和教育联合会于 2014 年 8 月 3 日至 2018 年 9 月 13 日进行。参与者分为受伤后 72 小时内飞行和不飞行的两组。所有纳入最终分析的参与者均有完整的感兴趣数据，且在研究期间仅发生 1 次损伤。数据分析于 2018 年 9 月至 2020 年 3 月进行。
恢复结果的衡量标准是从损伤到恢复活动、上学和基线症状的时间（以天为单位）。症状和头痛严重程度评分来自运动性脑震荡评估工具-第三版。两组的评分均在基线和受伤后中位数 2 天进行。
共有 92 名飞行参与者（平均[标准差]年龄，19.1[1.2]岁；55 名男性[59.8%]）和 1383 名未飞行参与者（平均[标准差]年龄，18.9[1.3]岁；809 名男性[58.5%]）纳入症状恢复结果分析（分析 1）。同样，100 名飞行参与者（平均[标准差]年龄，19.2[1.2]岁；63 名男性[63.0%]）和 1577 名未飞行参与者（平均[标准差]年龄，18.9[1.3]岁；916 名男性[58.1%]）纳入症状严重程度结果分析（分析 2）。在恢复结果测量方面，两组之间没有显著的组间差异。同样，两组在症状（估计平均差异，0.029；95%置信区间，-0.083 至 0.144；P=0.67）或头痛（估计平均差异，-0.007；95%置信区间，-0.094 至 0.081；P=0.91）严重程度评分方面也没有组间差异。
脑震荡后早期的飞机旅行与脑震荡症状的恢复或严重程度无关。这些发现可能有助于指导运动员脑震荡后飞行旅行的未来建议。
