Subsequent Injuries Characteristics Following A Sports-related Concussion Among High School Athletes

Concussions remain one of the most common injuries occurring among high school athletes. Following a sports-related concussion (SRC), athletes have a greater likelihood of sustaining a subsequent injury (SI). Thus, SRC may be a risk factor for another injury - especially within the lower extremity - even after being cleared to return-to-play (RTP). PURPOSE: To examine SI within six months after RTP from a SRC among high school athletes. METHODS: Using a hospital electronic medical record system, 583 SRC (63.6% male; M ± SD: age = 16.0 ± 1.3 Y) were identified between July 2019 and June 2022 from 27 area schools. These cases were retrospectively evaluated for a SI six months following the SRC. Demographics and SI characteristics were analyzed using descriptive statistics. A Kaplan-Meier curve was used to assess survivorship using the time to the first SI. RESULTS: There was a total of 242 (41.5%) SI within 6 months of the SRC and 81% (n = 196) sustained one SI. Majority of the initial SI (n = 118, 60.2%) occurred within 60 d from the SRC. The estimated probability of not having a SI was 79.8% (95% CI: 0.77, 0.83) and 66.6% (95% CI: 0.63, 0.71) within 60 and 180 d from the SRC, respectively (Figure 1). The average length of time (LOT) from the SRC to the first SI was 57.9 ± 38.9 d. Of the 583 SRC, 426 (73.1%) had a RTP date recorded. The mean LOT to RTP from the SRC was 16.1 ± 17.1 d and to the first SI was 54.4 ± 48.7 d, respectively. Most of the initial SI happened while participating in a sport (n = 183, 93.4%) and during a competition (n = 92, 46.9%) or practice (n = 52, 26.5%). The top three SI classifications were sprains (n = 54, 27.6%), strains (n = 29, 14.8%), and concussions/sub-concussive events (n = 26, 13.3%). CONCLUSION: Within this sample, it was estimated that between 29.5% and 37.2% of high school athletes would have a SI within 6 months of sustaining a SRC. This data may be useful for healthcare professionals to monitor SI following a SRC and potentially influence preventative programs and/or trainings.