|
Abstract
|
[[SafetyLit note: In May 2009, the U.S. state of Washington passed a new bill called the Lystedt Law, which protects young athletes from the life threatening or potentially life-long consequences that returning to the game too soon can cause. The law, named after Zackery Lystedt, a young athlete who was permanently disabled after sustaining a concussion in 2006, and prematurely returned to the game, requires any youth showing signs of a concussion to be examined and cleared by a licensed health care provider before being allowed to return to play.
Sometimes referred to as the shake-it-off law, Zack Lystedt’s story emphasizes why “shaking it off” puts players at risk for serious injury. — US Centers for Disease Control ]]
BACKGROUND: A previous report revealed an average of 7.2 (0.67 per 100,000 participants) sport-related structural brain injuries (SRSBIs) with macroscopic lesions per year in high school (HS) and college football players. The Lystedt law and other rule changes have been implemented with intent to reduce the risk of brain injury in American football.
HYPOTHESIS: To update the profile of SRSBIs in HS and college football players and evaluate the efficacy of legislation intended to reduce brain injuries.
STUDY DESIGN: Descriptive epidemiology study.
LEVEL OF EVIDENCE: Level 4.
METHODS: We retrospectively reviewed 18 academic years (July 2002 through June 2020) of SRSBIs catalogued by the National Registry of Catastrophic Sports Injuries. The incidence of SRSBIs was assessed at the HS level during the pre (July 2002 through June 2009), transitional (July 2009 through June 2014), and post (July 2014 through June 2020) universal adoption time periods of the Lystedt law. In addition, the incidence of SRSBIs during the second half of the study (2011-2012 through 2019-2020) was compared with the first half of the study (2002-2003 through 2010-2011).
RESULTS: During the study period, there was a total of 228 SRSBIs (12.7 per year, 1.01 per 100,000 participants): 212 (93%, 11.8 per year, 1.00 per 100,000) in HS athletes and 16 (7%, 0.89 per year, 1.17 per 100,000) in college athletes. There were 52 fatalities (2.9 per year, 0.22 per 100,000 participants) with 46 (2.56 per year, 0.22 per 100,000) in HS athletes and 6 (0.33 per year, 0.43/100,000) in college athletes. There was no significant difference in risk of HS total SRSBIs or fatalities during the 3 Lystedt periods. The risk of combined SRSBI cases [relative risk (RR) = 1.22, P = 0.13] and fatalities (RR = 1.20, P = 0.52) was similar in the second half of the study compared with the first half of the study.
CONCLUSION: Despite implementation of rule changes intended to reduce head injury, in particular the Lystedt law, the incidence of SRSBIs has remained unchanged. Further research is necessary to develop effective prevention programs for SRSBIs.
CLINICAL RELEVANCE: SRSBIs remain a persistent problem in HS and college American football. The recent head injury rule changes have not been effective at reducing SRSBIs.
Language: en |