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Cited by 50Traumatic Brain Injury ResearchSports injuries and preventionTraumatic Brain Injury and Neurovascular Disturbances

Sex-specific Outcomes and Predictors of Concussion Recovery

Davis-Hayes, Cecilia, Gossett, James D., Levine, William N., Shams, Tanzid, Harada, Jumpei, Mitnick, Jeremy, Noble, James·2017·Journal of the American Academy of Orthopaedic Surgeons
DOI 10.5435/jaaos-d-17-00276
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Abstract

Introduction: Sports-related concussion (SRC) is a substantial concern in collegiate athletics. Some studies of SRC that make comparisons by sex are limited by sample size, follow-up duration, or referral bias. Sex-specific predictors of occurrence and recovery are uncertain. Methods: A 15-year retrospective cohort study identified 1,200 Columbia University varsity athletes (822 male [68.5%], 378 female [31.5%]) at risk of collegiate SRC. Results: A total of 228 athletes experienced at least one collegiate concussion, including 88 female athletes (23.3% of female athletes) and 140 male athletes (17.0% of male athletes) ( P = 0.01); follow-up data were available on 97.8% of these athletes. Postconcussion symptoms were similar by sex, with the exception of sleep disturbance (29.3% of male athletes versus 42.0% of female athletes; P = 0.048) and memory impairment (43.6% of male athletes versus 30.7% of female athletes; P = 0.052), although the latter difference was not statistically significant. Risk factors for collegiate concussion included female sex (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.1 to 2.0) or precollegiate concussion (OR, 2.9; 95% CI, 2.2 to 3.9). Prolonged recovery was predicted by the presence of eight or more postconcussion symptoms for all athletes (OR, 3.77; 95% CI, 1.68 to 8.46) and for female athletes only (OR, 8.24; 95% CI, 1.58 to 43.0); this finding was not statistically significant for male athletes. Discussion: Female athletes were more likely than male athletes to experience concussion. Increasing numbers of prior concussions predicted recurrence. Although most postconcussion symptoms were highly intercorrelated, the total number of symptoms predicted a prolonged recovery period. Conclusion: This study confirms sex-based differences in SRCs. Longitudinal studies of collegiate cohorts should attempt to limit follow-up bias and offer opportunities to clarify determinants of SRC.

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Authors
Davis-Hayes, C., Gossett, J. D., Levine, W. N., Shams, T., Harada, J., Mitnick, J., & Noble, J.
Affiliations
East Tennessee State University (US)
ORCID
Venue
Journal of the American Academy of Orthopaedic Surgeons
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2017-12
Volume
25
Issue
12
Pages
818-828
ISSN
  • 1067-151X (ISSN-L)
  • 1940-5480
DOI
10.5435/jaaos-d-17-00276
OpenAlex
W2768868368
Cited by
50
References
37
Citations by year
2026: 3 · 2025: 1 · 2024: 5 · 2023: 5 · 2022: 2 · 2021: 11 · 2020: 7 · 2019: 10 · 2018: 5 · 2017: 1
FWCI
4.95
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of the American Academy of Orthopaedic Surgeons (publishedVersion)
  • PubMed (publishedVersion)
  • Digital Commons - East Tennessee State University (East Tennessee State University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
  • Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
Keywords
sports-related concussion, sex differences, concussion recovery, post-concussion symptoms, sleep disorders, memory impairment, concussion risk factors, female athletes, collegiate athletes
MeSH terms
Adolescent, Athletic Injuries, Brain Concussion, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Recurrence, Retrospective Studies, Risk Factors, Sex Factors, Universities, Post-Concussion Syndrome, Young Adult

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