Children with a previous concussion have four times the risk of sustaining a concussion as those children with no previous concussion history, according to a new study.
Children With Concussion Have 4X Repeat Risk
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Secondary#concussion#youthathletes
In the study, “What is the risk of recurrent concussion in children and adolescents aged 5-18 years? A systematic review and meta-analysis” published online June 1, 2021, in the British Journal of Sports Medicine, the researchers sought to better understand concussion risk in children.
Proper identification of concussion in youth sports is still a challenge. According to the U.S. Centers for Disease Control and Prevention, about 7 in 10 young athletes with a possible concussion continue to play. And 4 out of the 10 report that their coaches were unaware they had a possible concussion.
Seven studies including 23,411 children were included in the systematic review that was based on searches of four electronic databases: MEDLINE, Embase, CINAHL, and SPORTDiscus).
All the studies compared concussion risk in children aged 5 to 18 years with and without a previous concussion history and reported risk estimates. For the meta-analysis, the risk of bias was calculated using the Newcastle-Ottawa Scale.
The primary outcomes were number of children with and without a previous lifetime history of concussion who sustained a concussion during each study period.
Overall, pooled risk of sustaining a concussion was more than three times greater in children with a previous concussion compared with those with no previous concussion (RR = 3.64; 95% CI: 2.68 to 4.96; p < 0.0001; I2 = 90.55%)
The researchers, however, noted that direct comparison of concussion risk between male and female athletes was not possible because of lack of sex-stratified data.
“Previously concussed children have four times the risk of sustaining a concussion compared with those with no previous concussion history. This should be a consideration for clinicians in return to sport decision-making. Future studies examining subsequent recurrent concussion in youth sports must consider sex differences,” 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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