Back to school season may mean surge in concussion risk

When children return to school each fall they face at least twice the concussion risk they had during summer vacation, a U.S. study suggests.

For boys aged 10 to 19, the concussion rate surges to 7.0 cases for each 1,000 people in the autumn from 2.9 cases per 1,000 in the summer, according to an analysis of medical claims for members of Blue Cross and Blue Shield health plans.

Concussion rates for girls in that age group climb to 3.7 cases for each 1,000 people in the fall from just 1.9 cases per 1,000 in the summer.

While the study didn't examine why injuries spike in the fall, it may have something to do with the type of sports kids play at this time of year, said Dr. Trent Haywood, chief medical officer for the Blue Cross Blue Shield Association, Chicago-based federation of 36 independent Blue Cross and Blue Shield companies.

"The fall season does correlate with contact sports, such as football, soccer and ice hockey, that are more prone for minor traumatic brain injuries," Haywood said by email.

"It is important for coaches and parents to realize there is no current evidence that helmets, head gear or mouth guards decrease the incidence of concussions," Haywood added.

To assess trends in concussion rates, researchers examined data from medical claims on 936,630 insurance plan members who were diagnosed with concussion from 2010 through 2015. The analysis, published on the BCBS website, includes a subset of people with commercial insurance sold by 36 Blue Cross and Blue Shield plans.

Overall, concussion diagnoses rose 43 percent nationwide during the study period.

This was driven largely by a 71 percent increase in concussions for patients aged 10 to 19; diagnoses for patients aged 20 to 64 increased 26 percent.

Even though young males get the most concussions, the injury rate surged more for young females, the analysis also found.

The good news is that these surges in diagnoses may not necessarily be driven just by an increase in injuries, said Huiyun Xiang, director of Center for Pediatric Trauma Research, Nationwide Children's Hospital in Columbus, Ohio.

"The significant increase was more likely to be caused by greater awareness among athletes, parents and coaches around the need to properly diagnose and treat these head injuries," Xiang, who wasn't involved in the study, said by email.

Researchers also looked at what's known as post-concussion syndrome, a complex disorder that can include symptoms like dizziness or headaches and last for weeks or months after an injury.

Across all ages, the percentage of concussion patients diagnosed with post-concussion syndrome nearly doubled from 7.3 percent to 13.2 percent during the study period.

About 12 percent of younger concussion patients got this diagnosis in 2015, as did about 16 percent of older patients.

This, too, may be driven by increased awareness among parents and coaches about when it's safe for injured athletes to return to practice and competition.

"The timing of this increase in concussive diagnoses (2010-2015) corresponds to the implementation of policies that require better monitoring through medical clearance prior to returning to play," Carolyn McCarty, a researcher at the University of Washington and Seattle Children's Hospital who wasn't involved in the study, said by email.

Concussion rates found in the study add to a growing body of evidence suggesting that parents, coaches and athletes are doing a better job of removing athletes from play as soon as a head injury is suspected, said Anthony Kontos, research director of the sports medicine concussion program at the University of Pittsburgh Medical Center.

But even as more athletes are getting diagnosed, not all of them are getting necessary follow-up treatment, Kontos, who wasn't involved in the study, said by email.

"We need to also focus on making sure young athletes receive proper care following their concussion, so that they can recover fully and return to their sport in the safest manner possible," Kontos said.

SOURCE: http://bit.ly/2dko9QA Blue Cross Blue Shield Association, online September 27, 2016.