Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Investigation performed at Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Am J Sports Med. 2021 Jun;49(7):1929-1937. doi: 10.1177/03635465211008596. Epub 2021 May 6.
The sex of an athlete is thought to modulate concussion incidence; however, the effects of sex on concussion severity and recovery are less clear.
To evaluate sex differences in concussion severity and recovery using a large, heterogeneous sample of young student-athletes with the goal of understanding how sex affects concussion outcomes in young athletes.
Cohort study; Level of evidence, 3.
The Immediate Post-Concussion Assessment and Cognitive Testing results of 11,563 baseline and 5216 postinjury tests were used to calculate the incidence of concussion of adolescent male and female student-athletes ages 12 to 22 years (median, 15 years). The postinjury tests of 3465 male and 1751 female student-athletes evaluated for concussion or head trauma were used to assess differences in the Severity Index (SI) and recovery. Chi-square tests and tests were used to compare differences in demographic characteristics, incidence, and SI between the 2 cohorts. Multivariable linear, logistic, and Cox proportional hazards regressions were used to control for differences between cohorts in analyses of incidence, SI, and recovery.
When we controlled for demographic differences, female participants had higher odds of concussion (odds ratio, 1.62; 95% CI, 1.40-1.86; < .0001) and higher SI after concussion (β = 0.67; 95% CI, 0.02-1.32; = .04). This discrepancy in SI was a result of differences in Symptom (2.40 vs 2.94; < .0001) and Processing Speed (0.91 vs 1.06; = .01) composite scores between male and female participants, respectively. We found no effect of sex on time to recovery when controlling for initial concussion SI (hazard ratio, 0.94; 95% CI, 0.78-1.12; = .48).
Using large, multisport cohorts, this study provides evidence that female athletes are at higher risk for more concussions and these concussions are more severe, but male and female athletes have similar recovery times when the analysis controls for initial concussion SI.
人们认为运动员的性别会影响脑震荡的发生率；然而，性别的影响对于脑震荡的严重程度和恢复情况却不太明确。
利用大量异质的青少年运动员样本，评估脑震荡严重程度和恢复情况的性别差异，旨在了解性别对青少年运动员脑震荡结局的影响。
队列研究；证据水平，3 级。
使用即时脑震荡后评估和认知测试（Immediate Post-Concussion Assessment and Cognitive Testing）的结果，计算了 11563 名基线和 5216 名受伤后测试的 12~22 岁青少年男性和女性运动员的脑震荡发生率（中位数为 15 岁）。对 3465 名男性和 1751 名因脑震荡或头部创伤接受评估的运动员的受伤后测试进行分析，以评估严重程度指数（Severity Index，SI）和恢复情况的差异。使用卡方检验和 t 检验比较了 2 个队列之间的人口统计学特征、发生率和 SI 的差异。多变量线性、逻辑和 Cox 比例风险回归用于控制队列之间的差异，分析发生率、SI 和恢复情况。
当我们控制人口统计学差异时，女性参与者发生脑震荡的可能性更高（优势比，1.62；95%置信区间，1.401.86；<.0001），且脑震荡后的 SI 更高（β=0.67；95%置信区间，0.021.32；=.04）。这种 SI 差异是由于男性和女性参与者在症状（2.40 对 2.94；<.0001）和处理速度（0.91 对 1.06；=.01）复合评分上的差异所致。当控制初始脑震荡 SI 时，我们发现性别对恢复时间没有影响（风险比，0.94；95%置信区间，0.78~1.12；=.48）。
使用大型多运动项目队列，本研究提供了证据表明，女性运动员发生更多脑震荡的风险更高，且这些脑震荡更为严重，但当分析控制初始脑震荡 SI 时，男性和女性运动员的恢复时间相似。
