Contrasting characteristics and outcomes of sports-related and non–sports-related traumatic brain injury

Ntikas, M, Stewart, W, Ietswaart, M, Hunter, AM ORCID: https://orcid.org/0000-0001-7562-6145, Maas, AIR, Menon, DK and Wilson, L, 2024. Contrasting characteristics and outcomes of sports-related and non–sports-related traumatic brain injury. JAMA Network Open, 7 (1): e2353318. ISSN 2574-3805

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Abstract

Importance

Exposure to traumatic brain injury (TBI) has raised widespread concern over participation in sports, particularly over possible long-term consequences. However, little is known about the outcomes of individuals presenting to hospitals with sports-related TBI.

Objective

To compare the characteristics and outcomes of individuals presenting to hospitals with sports-related and non–sports-related TBI.

Design, Setting, and Participants

The CENTER-TBI (Collaborative European NeuroTrauma Effectiveness Research in TBI) observational cohort study was conducted at hospitals in 18 countries. The study enrolled 4509 patients who had TBI and had an indication for computed tomography (CT), of whom 4360 were 16 years or older. Outcomes were assessed at 3 and 6 months, and groups were compared using regression analyses adjusting for clinical and demographic differences. Data were collected between December 9, 2014, and December 17, 2017, and analyzed from August 2022 to March 2023.

Exposure

Sports-related and non–sports-related TBI with subgroups selected by severity of injury.

Main Outcomes and Measures

The main outcome was the Glasgow Outcome Scale–Extended (GOSE) at 6 months, with secondary outcomes covering postconcussion symptoms, health-related quality of life, and mental health.

Results

A total of 4360 patients were studied, including 256 (6%) with sports-related TBI (mean [SD] age, 38.9 [18.1] years; 161 [63%] male) and 4104 with non–sports-related TBI (mean [SD] age, 51.0 [20.2] years; 2773 [68%] male). Compared with patients with non–sports-related TBI, patients with sports-related TBI were younger, more likely to have tertiary education, more likely to be previously healthy, and less likely to have a major extracranial injury. After adjustment, the groups did not differ in incomplete recovery (GOSE scores <8) at 6 months (odds ratio [OR], 1.27; 95% CI, 0.90-1.78; P = .22 for all patients; OR, 1.20; 95% CI, 0.83-1.73; P = .34 for those with mild TBI; and OR, 1.19; 95% CI, 0.74-1.92; P = .65 for those with mild TBI and negative CT findings). At 6 months, there was incomplete recovery in 103 of 223 patients (46%) with outcomes in the sports-related TBI group, 65 of 168 (39%) in those with mild sports-related TBI, and 30 of 98 (31%) in those with mild sports-related TBI and negative CT findings. In contrast, at 6 months, the sports-related TBI group had lower prevalence of anxiety, depression, posttraumatic stress disorder, and postconcussion symptoms than the non–sports-related group.

Conclusions and Relevance

In this cohort study of 4360 patients with TBI, functional limitations 6 months after injury were common after sports-related TBI, even mild sports-related TBI. Persisting impairment was evident in the sports-related TBI group despite better recovery compared with non–sports-related TBI on measures of mental health and postconcussion symptoms. These findings caution against taking an overoptimistic view of outcomes after sports-related TBI, even if the initial injury appears mild.

Item Type:	Journal article
Publication Title:	JAMA Network Open
Creators:	Ntikas, M., Stewart, W., Ietswaart, M., Hunter, A.M., Maas, A.I.R., Menon, D.K. and Wilson, L.
Publisher:	American Medical Association (AMA)
Date:	2024
Volume:	7
Number:	1
ISSN:	2574-3805
Identifiers:	Number Type 10.1001/jamanetworkopen.2023.53318 DOI 1898130 Other
Rights:	© 2024 Ntikas M et al. This is an open access article distributed under the terms of the CC-BY License.
Divisions:	Schools > School of Science and Technology
Record created by:	Melissa Cornwell
Date Added:	31 May 2024 08:40
Last Modified:	31 May 2024 08:40
URI:	https://irep.ntu.ac.uk/id/eprint/51496

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