Sidhar Kartik, Baugh Christine M, Wilson Julie C, Spittler Jack, Walker Gregory A, Armento Aubrey M, Howell David R
Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA.
Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA.
J Clin Transl Res. 2022 Jul 18;8(4):292-298. eCollection 2022 Aug 29.
While healthcare and health outcome disparities have been studied across a variety of different injuries, their relation to concussion incidence and management are relatively understudied.
The aim of this study was to evaluate the association between history of concussion or musculoskeletal injury, and family affluence and/or school-level measures of socioeconomic status.
We conducted a cross-sectional study of adolescent athletes in a local school district. Adolescent athletes ( = 192; mean age = 15.3, SD = 1.6 years; 49% female), who presented for a pre-participation physical evaluation reported concussion and injury history, and family affluence scale (FAS) scores. We also examined the percent of students on free/reduced lunch at each school compared to state averages. Independent variables, individual FAS score and school-based marker of socioeconomic status, were compared between those with and without a history of concussion and time-loss musculoskeletal injury.
Of the participants, 40 (21%) reported a history of concussion. Athletes with a concussion history had significantly lower FAS scores than athletes without a history of concussion (mean difference = 0.7, 95%CI = 0.1, 1.4; = 0.027). There was no significant difference in FAS scores between those with and without a history of time-loss musculoskeletal injury (mean difference = 0.0, 95% CI = -0.5, 0.5; = 0.97). Athletes with a history of concussion had a higher proportion of a prior time-loss musculoskeletal injury (68% vs. 32%; < 0.001). After adjusting for age, school free-reduced lunch rate, and history of musculoskeletal injury, a lower FAS score was associated with concussion history (adjusted odds ratio = 0.79; 95% CI = 0.64, 0.96; = 0.019). Concussion and musculoskeletal injury were not associated with school-level markers of socioeconomic status.
Lower individual measures, but not school-level measures, of socioeconomic status were associated with a history of concussion in our sample of adolescent athletes.
Enhance providers' understanding of how socioeconomic factors may impact concussion history and empower providers to adequately screen for and provide concussion education to mitigate disparities.
虽然针对各种不同损伤的医疗保健和健康结果差异已得到研究，但它们与脑震荡发生率及管理之间的关系相对研究较少。
本研究的目的是评估脑震荡或肌肉骨骼损伤史与家庭富裕程度和/或学校层面社会经济地位指标之间的关联。
我们对当地学区的青少年运动员进行了一项横断面研究。前来进行赛前身体评估的青少年运动员（n = 192；平均年龄 = 15.3岁，标准差 = 1.6岁；49%为女性）报告了脑震荡和损伤史以及家庭富裕量表（FAS）得分。我们还比较了每所学校享受免费/减价午餐的学生比例与州平均水平。在有和没有脑震荡史及导致误工的肌肉骨骼损伤史的人群之间，比较了自变量、个人FAS得分和基于学校的社会经济地位指标。
在参与者中，40人（21%）报告有脑震荡史。有脑震荡史的运动员的FAS得分显著低于无脑震荡史的运动员（平均差异 = 0.7，95%置信区间 = 0.1，1.4；P = 0.027）。有和没有导致误工的肌肉骨骼损伤史的人群之间FAS得分无显著差异（平均差异 = 0.0，95%置信区间 = -0.5，0.5；P = 0.97）。有脑震荡史的运动员既往有导致误工的肌肉骨骼损伤的比例更高（68%对32%；P < 0.001）。在调整年龄、学校免费/减价午餐率和肌肉骨骼损伤史后，较低的FAS得分与脑震荡史相关（调整后的优势比 = 0.79；95%置信区间 = 0.64，0.96；P = 0.019）。脑震荡和肌肉骨骼损伤与学校层面的社会经济地位指标无关。
在我们的青少年运动员样本中，较低的个人社会经济地位指标（而非学校层面的指标）与脑震荡史相关。
增强医疗服务提供者对社会经济因素如何影响脑震荡史的理解，并使医疗服务提供者有能力进行充分筛查并提供脑震荡教育以减少差异。
