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Nationally, about 300,000 sports-related concussions (SRC) are hospital-treated each year (emergency department or hospitalized). However, most SRC is seen in urgent care, physician’s offices, or not at all. In 2011 Minnesota legislation was passed requiring coaches to remove student-athletes from competition if they show signs of concussion; youth are prohibited from returning to play until a healthcare provider gives permission. Prior legislation (1991) established a statewide traumatic brain injury registry (TBI) at the Minnesota Department of Health (MDH); the registry, currently with only hospitalized cases, could also include SRC. To better understand SRC and examine prevention/intervention strategies, MDH established a pilot registry system in August 2012 for reporting of SRC by high school athletic trainers.
METHODS:
Using the Report-It-Online (RIO) system as a model, the MDH developed an online registry system for high school athletic trainers to report concussions. The pilot system included 43 schools affiliated with Fairview Institute of Athletic Medicine, which provides athletic trainers. Trainers input information about concussions into a secured-online system; information includes whether the concussion occurred during practice or a game, date of return to class, and return to play. At one month post-injury each student’s academic progress is reported by an in-school academic contact.
RESULTS:
Within the first seven weeks, 316 students were diagnosed as having had a concussion. The majority were from football (67%) followed by soccer (16%) and volleyball (7%); ninth graders were reported more often than other grade levels (31%), and males reported more than females (72%). Most concussions were sustained during competition (versus practice). There was significant variance in reporting among the 43 schools. Less than 1 FTE was used to implement the system.
CONCLUSIONS:
A statewide registry system for high school SRC is feasible and resource efficient. Minnesota state rules would need to be modified to fully implement the system. Variance in reporting by school suggests differential identification and reporting by trainers, as well as differential risk that might be attributable to coaching or playing styles. Extended follow-up at 3 months post injury may be needed for individuals whose symptoms have not resolved at 1 month; resource facilitation may be an effective intervention in these individuals. Hospital data does not adequately describe SRC; online reporting can provide additional information regarding the burden of TBI in Minnesota. This registry system has potential to provide data to policy makers, school officials, and parents about rates and consequences associated with SRC.