Sports- and Recreation-Related Concussions in US Youth.
The incidence of sports- and recreation-related concussions (SRRCs) in the United States is unknown. More than 44 million youth participate in sports annually, thus understanding the frequency of SRRCs in children is important on a population level. Our objective was to determine the number of SRRCs occurring annually among US youth ≤18 years old.



We identified SRRCs using 3 national databases: MarketScan, National Electronic Injury Surveillance System, and National High School Sports Related Injury Surveillance System, Reporting Injury Online. We determined the number of SRRCs seen in health care settings (outpatient, inpatient, and emergency department) and SRRCs reported to certified high school athletic trainers (ATCs). We used these data and findings in recently published literature to generate a national estimate of SRRCs.



We estimate that between 1.1 and 1.9 million SRRCs occur annually in US children aged ≤18 years. Most children with SRRCs, 511 590 to 1 240 972, were not seen in health care settings. Of children with SRRCs seen in health care settings, most were seen as outpatients with 377 978 visits, compared with between 115 479 and 166 929 ED visits, and between 2886 and 4936 hospitalizations.



This study provides the most accurate and precise estimate to date of the number of concussions among US children annually. SRRCs are a common injury in children. Providers in all health care settings need to be trained in concussion care. There is a need for better surveillance to enhance our understanding of the epidemiology of concussions in youth.
Departments of Pediatrics and Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; mersine@uw.edu.
Mersine A
MA
Bryan
Departments of Pediatrics and Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; Epidemiology, and Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington;
Ali
A
Rowhani-Rahbar
Department of Epidemiology, Program for Injury Prevention Education and Research, Colorado School of Public Health at the University of Colorado Anschutz, Aurora, Colorado; and Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.
R Dawn
RD
Comstock
Departments of Pediatrics and Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; Epidemiology, and Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington;
Frederick
F
Rivara
D000293:Adolescent; D001265:Athletic Injuries / Q000453:epidemiology*; D001924:Brain Concussion / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011998:Recreation; D014481:United States / Q000453:epidemiology