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Journal Article

Citation

Li AY, Durbin JR, Hannah TC, Ali M, Spiera Z, Marayati NF, Dreher N, Schupper AJ, Kuohn L, Gometz A, Lovell MR, Choudhri TF. Brain Inj. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Informa - Taylor and Francis Group)

DOI

10.1080/02699052.2022.2035435

PMID

35113735

Abstract

BACKGROUND: High altitude may affect concussion, but prior studies are limited. We tested whether high altitude affects sport-related concussion (SRC) incidence, severity, and recovery.

METHODS: Twenty-five thousand eight hundred fifteen baseline and post-injury Immediate Post-Concussion Assessment and Cognitive Testing results were compiled from Florida and Colorado, low (27 m or 62 m) and high (1,640 m or 1,991 m) altitude locations, respectively. Incidence, severity, and recovery of injury were compared between altitudes.

RESULTS: High altitude was associated with increased suspected concussion incidence (adjusted OR, 2.04 [95% CI, 1.86 to 2.24];P < .0001). However, high altitude was associated with lower concussion severity measured by Severity Index (SI) (adjusted OR, 0.42 [95% CI, 0.37 to 0.49];P < .0001). High altitude was associated with decreased recovery from post-concussive symptoms in the migraine (β, -2.72 [95% CI, -3.31 to -2.13]; P < .0001), cognitive (β, -1.88 [95% CI, -2.40 to -1.36]; P < .0001), and sleep symptom clusters (β, -0.30 [95% CI, -0.52 to -0.08]; P = .007). Athletes with initial SI≥8 showed prolonged neurocognitive dysfunction at high altitude (HR, 1.38 [95% CI, 1.06 to 1.81]; P = .02).

CONCLUSIONS: High altitude was associated with increased suspected concussions and prolonged recovery but less severe initial injury.


Language: en

Keywords

mild traumatic brain injury; high altitude; severity index; Sports related concussion

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