MJA
MJA

Increasing incidence of hospitalisation for sport-related concussion in Victoria, Australia

Med J Aust 2013; 198 (8): 427-430. || doi: 10.5694/mja12.11217

Summary

Objective: To describe trends in hospitalisation for sport-related concussion.

Design, setting and patients: Analysis of routinely collected hospital admissions data from all Victorian hospitals (public and private) over the 2002–03 to 2010–11 financial years for patients aged ≥ 15 years with a diagnosis of concussion and an ICD-10-AM external cause activity code indicating sport.

Main outcome measures: Number and cost of hospitalisations; rate of hospitalisation per 100 000 participants overall and for specific sports; and percentage change in frequency and hospitalisation rate per 100 000 participants over 9 years.

Results: There were 4745 hospitalisations of people aged ≥ 15 years for sport-related concussion, with a total hospital treatment cost of $17 944 799. The frequency of hospitalisation increased by 60.5% (95% CI, 41.7%–77.3%) over the 9 years, but could only partially be explained by increases in sports participation, as the rate per 100 000 participants also increased significantly, by 38.9% (95% CI, 17.5%–61.7%). After adjustment for participation, rates were highest for motor sports, equestrian activities, Australian football, rugby and roller sports. The greatest significant increases in rates were seen in roller sports, rugby, soccer and cycling.

Conclusions: The frequency and participation-adjusted rate of hospitalisation for sport-related concussion, both overall and across several sports, increased significantly over the 9 years. These findings, along with high levels of public concern, make prevention of head injury in sport a population health priority in Australia.

Please login with your free MJA account to view this article in full

  • Caroline F Finch1
  • Angela J Clapperton2
  • Paul McCrory3

  • 1 Centre for Healthy and Safe Sport, University of Ballarat, Ballarat, VIC.
  • 2 Victorian Injury Surveillance Unit, Monash Injury Research Institute, Monash University, Melbourne, VIC.
  • 3 Florey Neurosciences Institute, University of Melbourne, Melbourne, VIC.

Correspondence: c.finch@ballarat.edu.au

Acknowledgements: 

This study was partially funded by a grant from Sport and Recreation Victoria (SRV) within the Victorian Department of Planning and Community Development, and from funding from the International Olympic Committee (IOC). Caroline Finch was supported by a National Health and Medical Research Council (NHMRC) Principal Research Fellowship (ID: 565900), and Paul McCrory by an NHMRC Practitioner Fellowship. Angela Clapperton was supported by the Victorian Injury Surveillance Unit's core grant from the Victorian Department of Health.

Competing interests:

Caroline Finch receives, or has previously received, competitive research funding from the following bodies for research into concussion or head injury in sport and its prevention: NHMRC, Australian Research Council (ARC), IOC, International Rugby Board (IRB), Australian Football League Research Board (AFLRB), Australian Rugby Union, SRV and the Victorian Health Promotion Foundation (VicHealth). Paul McCrory currently receives financial research support from the NHMRC, University of Melbourne, IOC, SRV and Eastern Health; his previous competitive grant funding includes the ARC, IRB, University of Melbourne, University of Otago, National Hockey League (US), VicHealth, AFLRB, Royal Australasian College of Surgeons, and the Australian Sports Commission. He has received travel funding from the Medical Commission of the IOC, the Fédération Internationale de Football Association (FIFA), the American Academy of Neurology and the Jockey Club (UK). He receives book royalties from McGraw-Hill and from 2001 to 2008 was employed by the BMJ Publishing Group. He has conducted clinical drug trials on antimigraine (Glaxo Wellcome, Janssen-Cilag, Novartis, Parke-Davis; Schering) and antispasticity drugs (Ipsen) through the Eastern Clinical Research Unit in Melbourne. This drug trial work has not involved any financial payment to him directly. He received consultancy fees in 2010 from Axon Sports (US) for the development of educational material (which was not renewed) and has received support since 2005 from CogState Inc for research costs and the development of educational material. He is a cofounder and shareholder in two biomedical companies (involved in e-health and compression garment technologies) but does not hold any individual shares in any company related to concussion or brain injury assessment or technology. Angela Clapperton has no relevant disclosures.

  • 1. World Health Organization. Neurological disorders: public health challenges. Geneva: WHO, 2006. http://www.who.int/mental_health/neurology/neurodiso/en/index.html (accessed Feb 2012).
  • 2. Langlois JA, Rutland-Brown W, Wald MM. The epidemiology and impact of traumatic brain injury: a brief overview. J Head Trauma Rehabil 2006; 21: 375-378.
  • 3. Centers for Disease Control and Prevention (US). Incidence of traumatic brain injury in the United States, 2002 and 2003 updated data tables. Atlanta, Ga: CDC, 2007. http://www.cdc.gov/ncipc/pub-res/tbi_in_us_04/TBI_Incidents.htm (accessed Sep 2012).
  • 4. Helps Y, Henley G, Harrison JE. Hospital separations due to traumatic brain injury, Australia 2004–05. Canberra: AIHW, 2008. (AIHW Cat. No. INJCAT 116; Injury Research and Statistics Series No. 45.) http://www.aihw. gov.au/publication-detail/?id=6442468147 (accessed Feb 2012).
  • 5. Macciocchi SN, Barth JT, Alves W, et al. Neuropsychological functioning and recovery after mild head injury in collegiate athletes. Neurosurgery 1996; 39: 510-514.
  • 6. Echemendia RJ, Putukian M, Mackin RS, et al. Neuropsychological test performance prior to and following sports-related mild traumatic brain injury. Clin J Sport Med 2001; 11: 23-31.
  • 7. McCrory P, Meeuwisse W, Johnston K, et al. Consensus statement on concussion in sport 3rd international conference on concussion in sport held in Zurich, November 2008. Clin J Sport Med 2009; 19: 185-200.
  • 8. National Centre for Classification in Health. International statistical classification of diseases and related health problems, 10th revision, Australian modification (ICD-10-AM). 5th ed. Sydney: National Centre for Classification in Health, 2006.
  • 9. Delaney JS, Lacroix VJ, Gagne C, Antoniou J. Concussions among university football and soccer players: a pilot study. Clin J Sport Med 2001; 11: 234-240.
  • 10. Standing Committee on Recreation and Sport. Participation in exercise, recreation and sport annual reports 2002–2010. State and territory tables for Victoria. Canberra: Australian Sports Commission, 2012. http://www.ausport.gov.au/information/casro/ERASS/erass_past_reports (accessed Sep 2012).
  • 11. Faul M, Xu L, Wald MM, Coronado VG. Traumatic brain injury in the United States: emergency department visits, hospitalizations and deaths 2002–2006. Atlanta, Ga: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 2010. http://www.cdc. gov/TraumaticBrainInjury/tbi_ed.html (accessed Mar 2012).
  • 12. Hootman JM, Dick R, Agel J. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train 2007; 42: 311-319.
  • 13. Laker SR. Epidemiology of concussion and mild traumatic brain injury. PM R 2011; 3 (10 Suppl 2): S354-S358.
  • 14. Daneshvar DH, Nowinski CJ, McKee AC, Cantu RC. The epidemiology of sports-related concussion. Clin Sports Med 2011; 30: 1-17.
  • 15. Gilbert F, Partridge BJ. The need to tackle concussion in Australian football codes. Med J Aust 2012; 196: 561-563. <MJA full text>
  • 16. Finch C, Boufous S, Dennis R. Sports/leisure injury hospitalisation episodes in NSW, 2003-2004: sociodemographic and geographic patterns and sport-specific profiles. Sydney: NSW Injury Risk Management Research Centre, 2007. http://www.irmrc.unsw.edu.au/documents/irmrc SportsInjuryReport2-8-07forweb.pdf (accessed Jan 2013).
  • 17. Braham R, Finch CF, McCrory P. The incidence of head/neck/orofacial injuries in non-elite Australian football. J Sci Med Sport 2004; 7: 451-453.
  • 18. McIntosh AS, McCrory P, Finch CF, Wolfe R. Head, face and neck injury in youth rugby: incidence and risk factors. Br J Sports Med 2010; 44: 188-193.
  • 19. Hollis SJ, Stevenson MR, McIntosh AS, et al. Mild traumatic brain injury among a cohort of rugby union players: predictors for time to injury. Br J Sports Med 2011; 45: 997-999.
  • 20. Marar M, McIlvain NM, Fields SK, Comstock RD. Epidemiology of concussions among United States high school athletes in 20 sports. Am J Sports Med 2012; 40: 747-755.
  • 21. Powell JM, Ferraro JV, Dikmen SS, et al. Accuracy of mild traumatic brain injury diagnosis. Arch Phys Med Rehabil 2008; 89: 1550-1555.
  • 22. Finch CF, Boufous S. Do inadequacies in ICD-10-AM activity coded data lead to underestimates of the population frequency of sports/leisure injuries? Inj Prev 2008; 14: 202-204.
  • 23. McCrory P. The eighth wonder of the world: the mythology of concussion management. Br J Sports Med 1999; 33: 136-137.
  • 24. Ahmed OH, Sullivan SJ, Schneiders AG, McCrory PR. Concussion information online: evaluation of information quality, content and readability of concussion-related websites. Br J Sports Med 2012; 46: 675-683.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article