Male Youth Ice Hockey Concussion Incidence in a USA Hockey Membership–Adjusted Population: A Peak in 2011 and the Impact of Major Rule Changes

• Published in: Clinical journal of sport medicine Vol. 32; no. 2; pp. 122 - 127
• Main Authors: Morrissey, Patrick J., Shah, Neil V., Hayden, Andrew J., Zhou, Jack J., Bloom, Lee R., Aylyarov, Alexandr, Chatterjee, Dipal, Newman, Jared M., Hariri, Omar K., McCarthy, Matthew T., Hesham, Khalid, Urban, William P.
• Format: Journal Article
• Language: English
• Published: United States Clinical Journal of Sport Medicine 01-03-2022
• Subjects: Adolescent; Athletic Injuries - epidemiology; Athletic Injuries - etiology; Brain Concussion - complications; Hockey - injuries; Humans; Incidence; Male; Retrospective Studies; United States - epidemiology; United States
• ISSN: 1050-642X; 1536-3724
• DOI: 10.1097/JSM.0000000000000893

To investigate the incidence of youth ice hockey-related concussions preceding and following the implementation of new body-checking and head contact rules by USA hockey in 2011. We hypothesized a decrease in concussions after the rule change.
Retrospective analysis.
United States emergency department (ED) data queried in the National Electronic InjurySurveillance System (NEISS).
National Electronic Injury Surveillance System reported male youth (≤18 years) ice hockey concussion cases from January 1, 2002, to December 31, 2016. In total, 848 players were diagnosed with concussion, representing a national estimate of 17 374 cases.
Time, specifically years.
Incidences and incidence rates (measured per 10 000 person-years) of male youth ice hockey concussions. Annual trends were analyzed using descriptive and linear or polynomial regression analysis.
The national estimate of youth ice hockey-related concussions seen in US emergency departments (EDs) increased significantly from 656 in 2007 to 2042 in 2011 (P < 0.01). During the same period, their respective incidence increased significantly from 21.8 to 66.8 per 10 000, before dropping through 2016 (P < 0.05). After 2011, concussions decreased from 1965 in 2012 to 1292 in 2016 (P = 0.055). The gap in concussion incidence between the 11 to 12 and 13 to 14 divisions widened after 2011 (before 2011: 41 vs 49 per 10 000 person-years [P = 0.80]; after 2011: 45 and 89, respectively [P < 0.01]).
US EDs experienced a significant increase in youth ice hockey concussion visits from 2007 to 2011. After the 2011 rule changes, concussion visits decreased significantly from 2012 to 2016.