3.28 Sex Differences in Non-Sport Related Concussion: a Care Consortium Study

Objective To describe sex differences in non-sport related concussion (non-SRC). Design Descriptive epidemiology. Setting 30 colleges/universities and military service academies in the Concussion Assessment, Research and Education Consortium. Participants 1,036 cadets and athletes (n=555 females) with non-SRC (outside of competition/practice/training). Interventions Sex. Outcome Measures Injury proportion ratios (IPR) compared the proportion of injuries by sex (female referent) for diagnosing provider, longer recovery (≥14 days to asymptomatic and/or ≥24 days to return-to-play), mental status alterations, loss of consciousness (LOC), posttraumatic amnesia (PTA), retrograde amnesia (RGA), and hospital transport. Main Results A higher proportion of females with non-SRC were diagnosed by athletic trainers (IPR=0.83, 5%CI=0.69–0.98) or team physicians (IPR=0.38, 95%CI=0.27–0.54), whereas a higher proportion of males were diagnosed by (IPR=1.31, 95%CI=1.13–1.53) primary care physicians. Non-SRC mechanism of being struck by an object (IPR=0.79, 95%CI=0.66–0.94) or motor vehicle crash (IPR=0.76, 95%CI=0.6–0.97) accounted for a larger proportion in females, whereas fight/assault/altercation accounted for a larger proportion in males (IPR=2.75, 95%CI=1.6–4.75). A higher proportion of males reported altered mental status (IPR=1.33, 95%CI=1.17–1.51), LOC (IPR=1.54, 95%CI=1.14–2.09), PTA (IPR=1.7, 95%CI=1.25–2.3), RGA (IPR=1.95, 95%CI=1.26–3.02), and hospital transport (IPR=1.34, 95%CI=1.08–1.65), whereas a larger proportion of females had longer recovery (IPR=0.80 95%CI=0.71–0.91). Conclusions A greater proportion of males with a non-SRC reported to primary care physicians, had a fight/assault/altercation mechanism, and had altered mental status, LOC, PTA, RGA, and hospital transport, while a greater proportion of females reported to athletic trainers or team physicians, were struck by an object or in a motor vehicle crash, and had longer recovery.