Concussion in high school sports: findings from injury surveillance

Abstract

We aimed to examine the epidemiology of concussions within high school (HS) boys’ and girls’ sports, and to assess the incidence of concussion within HS sports during the timespan inclusive of the COVID-19 pandemic. We analyzed data captured within High School Reporting Information Online (HS RIO) during 2018/19-2022/23. Injury counts, rates (enumerated per 10,000 athlete-exposures (AEs)), and proportions were used to describe injury characteristics by sport, event type, injury mechanism, and injury history. Injury rate ratios (IRR) and accompanying 95% Confidence Intervals (CIs) were used to evaluate differential injury incidence across event types and sports. A total of 4663 concussions were reported during the study period (Rate = 3.50 per 10,000 AEs). Overall rates were highest in boys’ football (8.22 per 10,000 AEs) and girls’ soccer (6.11 per 10,000 AEs). Among sex-comparable sports, overall concussion rates were higher in girls’ sports as compared with boys’ sports (IRR = 2.15; 95%CI = [1.94, 2.37]). Concussion rates fluctuated across the study period and were lower during the COVID-19-impacted seasons, as compared with neighboring years. Our findings underscore the necessity for continuous surveillance of concussions in HS sports and suggest that concussion incidence in girls’ sports warrants targeted attention.