A new study confirms that not only are female athletes at higher risk for more concussions, those concussions tend to be more severe.
Female Athletes at Higher Risk of More Concussions
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Secondary#FemaleAthletes#concussions#severityindex
In the study, “Sex-Related Differences in the Incidence, Severity, and Recovery of Concussion in Adolescent Student-Athletes Between 2009 and 2019,” published May 06, 2021 in The American Journal of Sports Medicine, the researchers sought to evaluate sex differences in concussion severity and recovery.
“The sex of an athlete is thought to modulate concussion incidence; however, the effects of concussion severity and recovery are less clear,” they wrote.
The researchers used data from a large, diverse sample of young student-athletes. They calculated the incidence of concussion among male and female student-athletes between the ages of 12 to 22 years of age based on the immediate post-concussion assessment and cognitive testing results of 11,563 baseline and 5,216 postinjury tests. They then used the postinjury tests of 3,465 male and 1,751 female student-athletes to assess the differences in the Severity Index and recovery.
According to the data collected, when demographic differences were controlled for, the female athletes had higher odds of concussion (odds ratio, 1.62; 95% CI, 1.40-1.86; p < .0001) and higher Severity Index after concussion (β= 0.67; 95% CI, 0.02-1.32; p = .04).
The differences found in Severity Index scores were due to differences in Symptom (2.40 vs 2.94; p < .0001) and Processing Speed (0.91 vs. 1.06; p = .01), they reported. There was not however, any sex differences when it came to time to recovery, after the initial concussion Severity Index was controlled for (hazard ratio, 0.94; 95% CI, 0.78-1.12; p = .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 Severity Index,” the researchers wrote.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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