The Incidence of Sports-Related Concussion in Children and Adolescents: A Systematic Review and Meta-Analysis

Abstract

Abstract Background Sport-related concussions (SRC) are a concern for young athletes due to the potential for long-term health problems. This systematic review and meta-analysis aimed to provide a comprehensive overview of the literature exploring SRC incidence in youth sports to understand the associated risks. Methods Medline, Embase, SportDiscus, PsycInfo, and Web of Science databases were searched without language restrictions until March 2023. Studies were included if they i) reported data for calculation of SRC incidence, ii) were a prospective cohort study, and iii) included a sample aged ≤ 18 years. Studies that reported Athlete Exposure (AE) or Player Hours (PH) as SRC incidence data measures were included in a multi-level random-effects meta-analysis. Additional analysis explored SRC incidence based on age, gender, country, year of data collection, setting, and level of contact. Results Of the 5833 studies reviewed for eligibility, 109 studies were accepted for a systematic review and 93 in the meta-analysis. The pooled incidence rate of SRC per 1,000 AE was found to be 1.41 across 21 sports, and 4.16 per 1,000 PH across 7 sports. The highest incidence per 1,000 AE were in taekwondo, rugby union, and ice hockey, and the highest incidence per 1,000 PH were in rugby 7’s, rugby league, and rugby union. Conclusions This systematic review and meta-analysis can serve as an updated baseline for risk of concussion among youth athletes across various sports. Registration: This systematic review was registered on OSF registries (https://osf.io/v298s).