Medical Student Icahn School of Medicine at Mount Sinai New York City, New York, United States
Introduction: The ImPACT test is commonly used in adolescent and collegiate sports to assess for the presence of concussion with a high degree of specificity and sensitivity. While multiple factors may affect the number of games an athlete misses following head injury, analysis of the likelihood of missing games based upon sport type is poorly understood. The goal of this investigation was to assess which sports were most associated with missed games in a season following head injury.
Methods: We queried a database of 7445 post-head injury ImPACT tests taken from athletes aged 12-22 from 2009-2019. We used ANOVA, Mann-Whitney t-tests, and linear regression analyses to model the effect of sport type on games missed in a season while controlling for sex, age, baseline learning disability, and attention deficit/hyperactive disorders.
Results: Ice hockey (mean=2.070), track and field (mean=1.710), baseball (mean=1.567), and soccer (mean=1.414) had the highest number of average games missed due to head injury. Swimming (mean=0.6545), football (mean=0.7470), and cheerleading (mean=0.7490) had the lowest number of average games missed due to head injury. One-way ANOVA comparing mean games missed across sports was significant (p < 0.0001). Upon univariate analysis, football had significantly lower average games missed compared to baseball (p=0.0006), basketball (p=0.0049), ice hockey (p=0.0018), lacrosse (p=0.0002), soccer (p < 0.0001), softball (p=0.0262), and track and field (p=0.0174). In a multiple linear regression analysis, all these sports maintained significantly higher odds of missed games after head injury compared to football (For example: Lacrosse β=0.3609,95%CI: 0.1471-0.5748,p < 0.0009; Soccer β=0.5997,95%CI: 0.4132-0.7862, p< 0.0001; Volleyball β=0.3904, 95% CI: 0.1050-0.6758, p< 0.0073).
Conclusion : These results suggest that adolescents playing football miss fewer games after head injury than other contact and non-contact sports including lacrosse, soccer, and volleyball. Further research is needed to determine the factors affecting games missed across sport types in adolescent athletics including return to play protocols.
