Epidemiological Patterns of Initial and Subsequent Injuries in Collegiate Football Athletes.
BACKGROUND
A body of epidemiological studies has examined football injuries and associated risk factors among collegiate athletes. However, few existing studies specifically analyzed injury risk in terms of initial or subsequent injuries.


OBJECTIVE
To determine athlete-exposures (AEs) and rates of initial and subsequent injury among collegiate football athletes.


METHODS
Descriptive epidemiological study.


METHODS
Injury and exposure data collected from collegiate football players from two Division I universities (2007-2011) were analyzed. Rate of initial injury was calculated as the number of initial injuries divided by the total number of AEs for initial injuries, while the rate for subsequent injury was calculated as the number of subsequent injuries divided by the total number of AEs for subsequent injury. Poisson regression was used to determine injury rate ratio (subsequent vs initial injury), with adjustment for other covariates.


RESULTS
The total AEs during the study period were 67,564, resulting in an overall injury rate of 35.2 per 10,000 AEs. Rates for initial and subsequent injuries were 31.7 and 45.3 per 10,000 AEs, respectively, with a rate ratio (RR) of 1.4 for rate of subsequent injury vs rate of initial injury (95% CI, 1.1-1.9). Rate of injury appeared to increase with each successive injury. RR during games was 1.8 (95% CI, 1.1-3.0). The rate of subsequent injuries to the head, neck, and face was 10.9 per 10,000 AEs, nearly double the rate of initial injuries to the same sites (RR = 2.0; 95% CI, 1.1-3.5). For wide receivers, the rate of subsequent injuries was 2.2 times the rate of initial injuries (95% CI, 1.3-3.8), and for defensive linemen, the rate of subsequent injuries was 2.1 times the rate of initial injuries (95% CI, 1.1-3.9).


CONCLUSIONS
The method used in this study allows for a more accurate determination of injury risk among football players who have already been injured at least once. Further research is warranted to better identify which specific factors contribute to this increased risk for subsequent injury.
Medical Student Research Program, The Ohio State University College of Medicine, Columbus, Ohio, USA.|Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.
Jacob Z
JZ
Williams
Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.
Bhavna
B
Singichetti
Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.|Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China.
Hongmei
H
Li
Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.|Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio, USA.|Department of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA.
Henry
H
Xiang
Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio, USA.|Sports Medicine and Orthopedics, Nationwide Children's Hospital, Columbus, Ohio, USA.
Kevin E
KE
Klingele
Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.|Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio, USA.|Department of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA.
Jingzhen
J
Yang
D000293:Adolescent; D000328:Adult; D056352:Athletes / Q000706:statistics & numerical data; D001924:Brain Concussion / Q000453:epidemiology / Q000209:etiology; D005538:Football / Q000293:injuries* / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D012307:Risk Factors; D013334:Students; D014481:United States / Q000453:epidemiology; D014495:Universities; D055815:Young Adult
collegiate athletics; epidemiology; football (American); recurrent injury; subsequent injury