Introduction: Sports-related traumatic brain injury (TBI) is an important public health concern estimated to effect 300,000 to 3.8 million people annually. Although injuries to professional athletes dominate the media, they constitute a small proportion of the overall population. Here, we characterize the demographics of sports-related TBI in adults from a community-based trauma population and identify predictors of prolonged hospitalization, morbidity and mortality.
Methods: Utilizing the National Sample Program of the National Trauma Data Bank, retrospective analyses were performed in adults (age = 18-years) across five sporting categories – fall or interpersonal contact (FIC), roller sports, skiing / snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was utilized to characterize predictors of prolonged hospital stay, medical complications, inpatient mortality and hospital discharge disposition.
Results: From 2003-2012, 4,788 adult sports-related TBIs were documented in the NTDB, which represents 18,310 incidents nationally. Equestrian sports were the greatest contributors to sports-related TBI (45.2 %). Mild TBI constituted nearly 86% of injuries overall. Mean length of hospital and ICU stay was 4.25 ± 0.09 and 1.60 ± 0.06 days, respectively. Mortality was 3.1% across all patients, but statistically higher in roller sports (4.1%) and aquatic sports (7.7%). Age, hypotension, and severity of head and extracranial injury were statistically significant predictors of prolonged hospital and ICU stay, medical complication, failure to discharge home, and death. TBI during aquatic sports was similarly associated with prolonged ICU stay, hospital stay, medical complications, and failure to be discharged to home.
Conclusions: Age, hypotension, severity of head and extracranial injury, and mechanism of injury are important prognostic variables in adult sports-related TBI. Increasing TBI awareness and helmet utilization – with emphasis in equestrian sports and roller sports – are critical elements for reducing sports-related TBI in adults.
Patient Care: It raises awareness and validates clinical predictors of poor outcome of head trauma related to sports in non-professional adult athletes
Learning Objectives: By conclusion of this session, participants should be able to: 1) Describe the most common forms of sports-related trauma leading to TBI-related hospitalization in US trauma centers; 2) Describe predictors of morbidity and mortality in adult sports-related TBI; 3) Identify areas for improvement in increasing public awareness of TBI in non-professional athletics