Boltz Adrian J, Memmini Allyssa K, Brett Benjamin L, Snedden Traci R, Yengo-Kahn Aaron M, Chandran Avinash, Conway Darryl P, Shah Rushil, Pasquina Paul F, McAllister Thomas W, McCrea Michael A, Master Christina L, Broglio Steven P
Michigan Concussion Center, University of Michigan, Ann Arbor, MI.
Department of Health, Exercise and Sports Sciences, University of New Mexico, Albuquerque, NM.
Med Sci Sports Exerc. 2023 Dec 1;55(12):2180-2193. doi: 10.1249/MSS.0000000000003258. Epub 2023 Jul 27.
The objectives of this study are to 1) describe collegiate student-athlete (SA) race and household income and 2) evaluate time to normal academic performance (i.e., return to learn (RTL)), initiation of the return to play (iRTP) protocol, RTP protocol duration, and time to unrestricted RTP (URTP) after sustaining sport-related concussion (SRC).
Data were collected between 2014 and 2020 by the Concussion Assessment, Research, and Education Consortium. Baseline data were used to characterize participant demographics ( N = 22,819) and post-SRC outcomes ( n = 5485 SRC) in time to RTL ( n = 1724) and RTP outcomes ( n = 2646) by race. Descriptive statistics and nonparametric tests examined differences across race by demographic and injury characteristics. Kaplan-Meier curves estimated median days to RTL, iRTP protocol, RTP protocol completion, and URTP by race and covariate measures. Multivariable Cox proportional hazards regression assessed the effect of race on risk of RTL and RTP recovery time points.
SA largely identified as White (75%) followed by Black (14%), multiracial (7%), and Asian (3%). More than half (53%) of all SA reported a household income of >$120,000, whereas 41% of Black SA reported a household income <$60,000. Race was not associated with relative risk of RTL or iRTP but was associated with RTP protocol completion and URTP. Non-Black/non-White SA were 17% less likely (adjusted hazard ratio = 0.83; 95% confidence interval = 0.71, 0.97) to complete the RTP protocol, and Black SA were 17% more likely (adjusted hazard ratio = 1.17; 95% confidence interval = 1.05, 1.31) to reach the URTP time point compared with White SA.
The present findings suggest collegiate SA enrolled in the Concussion Assessment, Research, and Education Consortium are primarily White and come from household incomes well above the US median. Race was not associated with RTL or iRTP but was associated with RTP protocol duration and total time to URTP. Clinicians should be conscientious of how their implicit or preconceived biases may influence SRC management among National Collegiate Athletic Association SA.
本研究的目的是：1）描述大学生运动员（SA）的种族和家庭收入；2）评估在遭受与运动相关的脑震荡（SRC）后恢复正常学业表现的时间（即复学（RTL））、开始恢复比赛（iRTP）方案的时间、RTP方案持续时间以及恢复无限制比赛（URTP）的时间。
2014年至2020年期间，由脑震荡评估、研究和教育联盟收集数据。基线数据用于按种族及时描述参与者的人口统计学特征（N = 22,819）和SRC后的结果（n = 5485例SRC），包括RTL（n = 1724）和RTP结果（n = 2646）。描述性统计和非参数检验按人口统计学和损伤特征检查不同种族之间的差异。Kaplan-Meier曲线按种族和协变量测量估计达到RTL、iRTP方案、RTP方案完成和URTP的中位天数。多变量Cox比例风险回归评估种族对RTL风险和RTP恢复时间点的影响。
SA大多认定为白人（75%），其次是黑人（14%）、多种族（7%）和亚洲人（3%）。所有SA中超过一半（53%）报告家庭收入超过12万美元，而41%的黑人SA报告家庭收入低于6万美元。种族与RTL或iRTP的相对风险无关，但与RTP方案完成和URTP有关。非黑人/非白人SA完成RTP方案的可能性低17%（调整后风险比 = 0.83；95%置信区间 = 0.71, 0.97），与白人SA相比，黑人SA达到URTP时间点的可能性高17%（调整后风险比 = 1.17；95%置信区间 = 1.05, 1.31）。
目前的研究结果表明，参加脑震荡评估、研究和教育联盟的大学生SA主要是白人，家庭收入远高于美国中位数。种族与RTL或iRTP无关，但与RTP方案持续时间和达到URTP的总时间有关。临床医生应注意其隐性或先入为主的偏见可能如何影响美国国家大学生体育协会SA的SRC管理。
