Introduction: Concussion diagnosis and management is a topic of interest for health care, education, and government professionals. Given the evidence concerning the association of long term effects and cumulative insult of multiple concussions, we sought to identify risk factors in young athletes for repeat injury.

Methods: This study is a retrospective cohort analysis of our institution’s series of pediatric sports related concussions. Patient demographics, characteristics, and clinical features of concussion were analyzed in an unadjusted fashion. Bivariate analysis examined these variables in relation to occurrence of subsequent concussion. Multivariable analysis was then employed to evaluate for predictors of repeat injury.

Results: One hundred and ninety one patients with a mean age of 13.5 years were included for analysis. Relative to patients whose injury was associated with football, patients playing soccer (OR 5.36, 95% CI 1.18-24.5), ice hockey/skating (OR 6.97, 95% CI 1.60-30.37), and basketball (OR 5.99, 95% CI 1.23-29.07) were associated with a significant increased odds of suffering a subsequent concussion. History of prior concussion was also significantly associated with an increased odds of repeat injury following the index concussion, defined as the first concussion evaluated at our institution (OR 12.54, 95% CI 3.78-41.62). Relative to a concussion resulting from a mechanism involving blunt force to the head, patients with a concussion in the setting of a fall were significantly less likely to suffer a subsequent concussion (OR 0.19, 95% CI 0.05-0.71).

Conclusions: Efforts to protect young athletes are of immeasurable value given the potential life years at risk for productivity and quality of life. With the identification of specific sports, prior injury, and mechanism influencing risk of repeat injury, clinicians are more informed to assess and discuss both risk and potential consequences of concussions with young athletes and their families.

Patient Care: In identifying risk factors for repeat injury, neurosurgeons are better informed for their discussions with young patients and families regarding strategies to mitigate risk of further injury as well as potential implications of repeat injuries over time.

Learning Objectives: By the conclusion of this session, participants should be able to (1) Discuss factors that are identified as increasing risk for repeat injury from the series presented, (2) Discuss the risks and potential consequences of concussions with young athletes and their families.

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