Concussion: Mechanisms of Injury and Trends from 1997 to 2019.
Daniel Reid, Kalpit N. Shah, Evan J. Baum, Alan H. Daniels
Abstract
BACKGROUND: There is limited long-term epidemiological data focused on concussions in the United States. METHODS: The National Electronic Injury Surveillance System was queried from 1997 to 2019 for concussion diagnoses. National incidence rates, stratified by age and sex, were estimated. Injury mechanisms were ranked. RESULTS: From 1997 to 2019, there was a 3-fold increase in the diagnosis of concussion from 82,103 (95% CI 77,650-86,555) in 1997 to 261,722 (95% CI 212,156-311,288) in 2019 (p<0.001). Fall-related head-injury mechanisms were most common in very young (<5 year old) and older (>65 year old) patients. Sports-related injuries were most common in those age 5-24 years old. CONCLUSIONS: It remains unclear if the observed two-decade rise in reported concussions represents a true increase in incidence or is indicative of improvements in early detection, diagnosis, and treatment during this time period. Common injury mechanisms described highlight the need for improved age-specific safety recommendations.