Concussions are on the rise, especially in teens

From 2007 through 2014, the incidence of diagnosed concussions has increased in the general US population, due primarily to a large increases in adolescents, with an increase of 143% in kids aged 10 to 14 years and an increase of 87% in those 15 to 19 years old, according to researchers from the University of California, San Francisco, who published their results in the August 16, 2016 issue of the Orthopaedic Journal of Sports Medicine.

“Our study evaluated a large cross-section of the U.S. population,” said lead author Alan Zhang, MD, UCSF Health orthopaedic surgeon. “We were surprised to see that the increase in concussion cases over the past few years mainly were from adolescent patients aged 10 to 19.”

Dr. Zhang and colleagues conducted this study—the first to assess the trends in the incidence of concussion diagnoses across the general population according to age group in Americans—using health records from Humana Inc. from 8,828,248 members under the age of 65 years who had been diagnosed with concussion from 2007 through 2014. They categorized subjects according to year of diagnosis, age group, sex, concussion classification, and by whether the diagnosis was made in the emergency department or in a physician’s office.

In all, they found 43,884 diagnoses of concussion, 55% of which were in males. Individuals aged 15 to 19 years old had the highest incidence of concussion (16.5 per 1,000 patients), followed by those aged 10 to 14 years (10.5 per 1,000), those aged 20 to 24 years (5.2 per 1,000), and those aged 5 to 9 years (3.5 per 1,000).

Over half of concussions (56%) were diagnosed in the emergency department, compared with 29% in a physician’s office. The remaining 15% were diagnosed in urgent care or inpatient settings.

“Our study included health care settings in addition to the ED, demonstrating that while over half of all concussions were diagnosed in the ED of a hospital, approximately 30% of the diagnoses were made in a physician’s office. Capturing health care locations where a concussion can be initially diagnosed offers a more representative cross-sectional analysis. These data suggest that not only should emergency physicians have the knowledge and skills to care for patients with concussion, but outpatient clinicians also should have the confidence and competence to manage concussion cases,” noted Dr. Zhang and fellow researchers.

From 2007 to 2014, researchers found a 60% increase in concussions, from 3,529 to 8,217, respectively. The greatest increase was seen in those aged 10 to 14 years (increase of 143%) and 15 to 19 years (increase of 87%).

According to Dr. Zhang, who is also assistant professor of orthopaedic surgery at UCSF, this increase in adolescent concussions may be due to an increase in sports participation, and reflects an increased awareness of concussion by parents, coaches, students, sports medical staff, and physicians.