title: Incidence of Concussion in Youth Ice Hockey Players.
abstract: BACKGROUND
  Ice hockey is a fast-paced collision sport that entails both intentional (ie, body checking) and incidental contact that may involve the head. The objective of this study was to determine the incidence of concussions in relation to games/practices and age among competition-level youth ice hockey players (ages 12-18 years).
  
  
  METHODS
  Participants included 397 youth ice hockey players from Western Pennsylvania; Boston, Massachusetts; and Birmingham, Alabama, during the 2012-2013 and 2013-2014 youth ice hockey seasons. Incidence rates (IRs) and incidence rate ratios (IRRs) of concussion were calculated for games/practices and age groups.
  
  
  RESULTS
  A total of 23 369 (12 784 practice/10 585 game) athletic exposures (AEs) involving 37 medically diagnosed concussions occurred. More than 40% of concussions involved illegal contact. The combined IR for games and practices was 1.58 concussions per 1000 AEs. The IRR was 2.86 times (95% confidence interval 0.68-4.42) higher during games (2.49 per 1000 AEs) than practices (1.04 per 1000 AEs).
  
  
  CONCLUSIONS
  The overall IR for concussion in youth ice hockey was comparable to those reported in other youth collision sports. The game-to-practice IRR was lower than previously reported in ice hockey and other youth sports, although more concussions per exposure occurred in games compared with practices. Younger players had a higher rate of concussions than older players.
authors.affiliation: Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program- University of Pittsburgh, Pittsburgh, Pennsylvania; akontos@pitt.edu.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Kontos
authors.affiliation: Department of Health, Human Performance and Recreation/Office for Sport Concussion Research- University of Arkansas, Fayetteville, Arkansas;
authors.forename: R J
authors.initials: RJ
authors.lastname: Elbin
authors.affiliation: Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program- University of Pittsburgh, Pittsburgh, Pennsylvania;
authors.forename: Alicia
authors.initials: A
authors.lastname: Sufrinko
authors.affiliation: Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program- University of Pittsburgh, Pittsburgh, Pennsylvania; College of Medicine- Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania; and.
authors.forename: Scott
authors.initials: S
authors.lastname: Dakan
authors.affiliation: Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program- University of Pittsburgh, Pittsburgh, Pennsylvania;
authors.forename: Kylie
authors.initials: K
authors.lastname: Bookwalter
authors.affiliation: Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program- University of Pittsburgh, Pittsburgh, Pennsylvania;
authors.forename: Ali
authors.initials: A
authors.lastname: Price
authors.affiliation: Boston Children's Hospital /Harvard Medical School, Boston, Massachusetts Micheli Center for Sports Injury Prevention, Waltham, Massachusetts.
authors.forename: William P
authors.initials: WP
authors.lastname: Meehan
authors.affiliation: Department of Orthopaedic Surgery/UPMC Sports Medicine Concussion Program- University of Pittsburgh, Pittsburgh, Pennsylvania;
authors.forename: Michael W
authors.initials: MW
authors.lastname: Collins
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000407:Alabama / Q000453:epidemiology; D001900:Boston / Q000453:epidemiology; D001924:Brain Concussion / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006688:Hockey / Q000293:injuries*; D006801:Humans; D015994:Incidence; D008297:Male; D010414:Pennsylvania / Q000453:epidemiology; D011446:Prospective Studies