Characteristics and Incidence of Concussion Among a US Collegiate Undergraduate Population

Abstract

Importance: Concussion on university campuses is a significant health problem. Characterizing the incidence of concussion on college campuses may inform education and resource allocation policy at student health care centers.

Objectives: To establish a measure of concussion incidence among collegiate undergraduate students and to describe characteristics associated with concussion incidence, including sex, cause, and month.

Design, setting, and participants: This prospective cohort study included data from 3 academic years from August 2015 to April 2018 at a large, public university in the United States. Participants included any undergraduate student or varsity athlete who was diagnosed with at least 1 concussion during the academic year.

Exposures: Sport- and non-sport-related activities of undergraduate students.

Main outcomes and measures: Concussion diagnosis.

Results: Among 954 undergraduate students from the general undergraduate population with at least 1 concussion, including 502 men and 452 women, 1020 concussions were diagnosed in 3 academic years. During 2 academic years, a total of 80 concussions occurred among the varsity athlete population, including 26 men and 54 women. Overall, concussion incidence among both the general undergraduate population and varsity athletes was 132.4 (95% CI, 123.2-142.0) concussions per 10 000 students. Men sustained concussions at a rate of 126.1 (95% CI, 114.1-139.0) concussions per 10 000 students and women sustained concussions at a rate of 140.0 (95% CI, 126.2-155.3) concussions per 10 000 students for the 2016 to 2017 and 2017 to 2018 academic years. Concussion incidence peaked in August at the start of the academic year and the rate of non-sport-related concussions (81.0 [95% CI, 73.9-88.7] concussions per 10 000 students for academic years 2016-2017 and 2017-2018) was higher than the rate of sport-related concussions (51.5 [95% CI, 49.5-57.7] concussions per 10 000 students for academic years 2016-2017 and 2017-2018).

Conclusions and relevance: This cohort study found concussions to be common among this US collegiate population. While concussion is often associated with sport, the incidence of non-sport-related concussion was higher than that of sport-related concussion throughout the academic year. Additional research is warranted to determine if this incidence measure among undergraduate students is generalizable to other university populations.

Conflict of interest statement

Conflict of Interest Disclosures: Drs Bohr and McQueen reported directing the Pac-12 Concussions Coordinating Unit, funded through the Pacific (Pac)-12 Conference, National Collegiate Athletic Association, and Department of Defense. Dr McQueen reported receiving grants from the National Institutes of Health during the conduct of this study. No other disclosures were reported.

Figures

Figure.. Concussion Incidence by Cause During the Academic Year for the General Undergraduate Population

Non–sport-related concussions include concussions caused by falls, hits, motor vehicle crashes, and other causes.