Sex Differences Across Concussion Characteristics in US Service Academy Cadets: A CARE Consortium Study.

IF 9.3 1区医学 Q1 SPORT SCIENCES Sports Medicine Pub Date : 2024-11-01 Epub Date: 2024-07-12 DOI:10.1007/s40279-024-02068-3

Louise A Kelly, J B Caccese, D Jain, C L Master, L Lempke, A K Memmini, T A Buckley, J R Clugston, A Mozel, J T Eckner, A Susmarski, E Ermer, K L Cameron, S Chrisman, P Pasquina, S P Broglio, T W McAllister, M McCrea, C Esopenko

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Abstract

Objective: To describe sex differences in concussion characteristics in US Service Academy cadets.

Design: Descriptive epidemiology study.

Setting: Four US service academies.

Participants: 2209 cadets (n = 867 females, n = 1342 males).

Independent variable: Sex.

Outcome measures: Injury proportion ratios (IPR) compared the proportion of injuries by sex (females referent) for injury situation, certainty of diagnosis, prolonged recovery, recurrent injuries, mental status alterations, loss of consciousness (LOC), posttraumatic amnesia (PTA), retrograde amnesia (RGA), motor impairments, delayed symptom presentation, and immediate reporting.

Main results: Concussions from varsity/intercollegiate sports [IPR of 1.73, 95% confidence interval (CI) 1.43-2.10] and intramurals (IPR of 1.53, 95% CI 1.02-2.32) accounted for a larger proportion in males, whereas concussions outside of sport and military activities accounted for a smaller proportion among males (IPR of 0.70, 95% CI 0.58-0.85). The proportion of concussions with prolonged recovery was lower among males (IPR of 0.69, 95% CI 0.60-0.78), while concussions with altered mental status (IPR of 1.23, 95% CI 1.09-1.38), LOC (IPR of 1.67, 95% CI 1.17-2.37), PTA (IPR of 1.94, 95% CI 1.43-2.62), and RGA (IPR of 2.14, 95% CI 1.38-3.31) accounted for a larger proportion among males. A larger proportion of concussions that were immediately reported was observed in males (IPR of 1.15, 95% CI 1.00-2.31). Proportions of other characteristics (e.g., recurrent injuries) were not different between sexes.

Conclusions: A higher proportion of concussions occurred outside of sport and military training for female cadets, who also displayed proportionally longer recovery times than males, despite males demonstrating a higher proportion of LOC, PTA, and RGA. Possible factors may include different mechanisms of injury outside of sport and military training, different biopsychosocial states associated with sex or injury context, and delayed injury reporting when outside of an observed environment, possibly secondary to perceived stigma about reporting injuries.

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美国军校学员脑震荡特征的性别差异：CARE 联合研究。

目的：描述美国军校学员脑震荡特征的性别差异：描述美国军校学员脑震荡特征的性别差异：设计：描述性流行病学研究：参与者：2209名军校学员（女性867人，男性1342人）：结果测量受伤比例比（IPR）比较了受伤情况、诊断确定性、恢复期延长、反复受伤、精神状态改变、意识丧失（LOC）、创伤后遗忘症（PTA）、逆行性遗忘症（RGA）、运动障碍、症状延迟出现和立即报告等方面的性别（女性参考）受伤比例：校队/校际运动[IPR为1.73，95%置信区间（CI）为1.43-2.10]和校内比赛（IPR为1.53，95%置信区间（CI）为1.02-2.32）造成的脑震荡在男性中所占比例较大，而体育和军事活动以外造成的脑震荡在男性中所占比例较小（IPR为0.70，95%置信区间（CI）为0.58-0.85）。恢复期延长的脑震荡在男性中所占比例较低（IPR 为 0.69，95% CI 为 0.60-0.78），而精神状态改变（IPR 为 1.23，95% CI 为 1.09-1.38）、LOC（IPR 为 1.67，95% CI 为 1.17-2.37）、PTA（IPR 为 1.94，95% CI 为 1.43-2.62）和 RGA（IPR 为 2.14，95% CI 为 1.38-3.31）的脑震荡在男性中占较大比例。在立即报告的脑震荡中，男性所占比例较大（IPR 为 1.15，95% CI 为 1.00-2.31）。其他特征（如反复受伤）的比例在性别间没有差异：女学员在运动和军事训练之外发生脑震荡的比例较高，尽管男学员发生 LOC、PTA 和 RGA 的比例较高，但女学员的恢复时间也比男学员长。可能的因素包括在运动和军事训练之外受伤的不同机制、与性别或受伤背景相关的不同生物心理社会状态，以及在观察环境之外受伤时延迟报告，这可能与报告受伤的耻辱感有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sports Medicine 医学-运动科学

CiteScore

18.40

自引率

5.10%

发文量

165

审稿时长

6-12 weeks

期刊介绍： Sports Medicine focuses on providing definitive and comprehensive review articles that interpret and evaluate current literature, aiming to offer insights into research findings in the sports medicine and exercise field. The journal covers major topics such as sports medicine and sports science, medical syndromes associated with sport and exercise, clinical medicine's role in injury prevention and treatment, exercise for rehabilitation and health, and the application of physiological and biomechanical principles to specific sports. Types of Articles: Review Articles: Definitive and comprehensive reviews that interpret and evaluate current literature to provide rationale for and application of research findings. Leading/Current Opinion Articles: Overviews of contentious or emerging issues in the field. Original Research Articles: High-quality research articles. Enhanced Features: Additional features like slide sets, videos, and animations aimed at increasing the visibility, readership, and educational value of the journal's content. Plain Language Summaries: Summaries accompanying articles to assist readers in understanding important medical advances. Peer Review Process: All manuscripts undergo peer review by international experts to ensure quality and rigor. The journal also welcomes Letters to the Editor, which will be considered for publication.