Use of the ICECI and ICD-10 E-Coding structures to evaluate causes of head injury and concussion from sport and recreation participation in a school population

Issue title: Sports and Concussion

Guest editors: Barry Willer and John J. Leddy

Article type: Research Article

Authors: Kozlowski, Karl F.^{a; *} | Leddy, John J.^b | Tomita, Machiko^c | Bergen, Anne^d | Willer, Barry S.^e

Affiliations: [a] Department of Exercise and Nutrition Sciences-Program in Athletic Training, State University of New York at Buffalo, Buffalo, NY, USA | [b] Department of Orthopedics, State University of New York at Buffalo, Buffalo, NY, USA | [c] Department of Rehabilitation Sciences, State University of New York at Buffalo, Buffalo, NY, USA | [d] Department of Psychology, University of Guelph, Guelph, Ontario, Canada | [e] Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA | The State University of New York at Buffalo, Farber Hall, Main Street Campus, Buffalo, NY 14214-3079, USA

Correspondence: [*] Address for correspondence: Karl F. Kozlowski, Department of Exercise and Nutrition Sciences, Kimball Tower, Room 214A, University at Buffalo, Buffalo, NY 14214, USA. Tel.: +1 716 829 2941, Ext. 282; Fax: +1 716 829 2428; E-mail: kfk@buffalo.edu

Abstract: The purpose of this study was to identify the most common causes of head injury and associated symptoms of concussion in a population of school children (n = 1,372,979). Using standardized injury report forms, we identified the mechanisms of head injury associated with various sports/recreation activities and assessed each injury for the presence of concussion symptoms. Head injury reports (n = 7,765) were coded using the WHO's ICECI and ICD-10 E-codes. 1,338 Cases reported symptoms of concussion. The majority of head injuries occurred during School Free-Play/Recess (59.8%). Combative Sports and Wheeled Non-Motored Sports were the activities most often associated with concussion symptoms (rate of concussion (RC): 48.3% and 44.4%, respectively, p < 0.001). School Free-Play/Recess and Physical Education Classes were significantly less likely to have head injuries associated with concussion (RC: 16.0%, p < 0.001, and 12.4%, p = 0.034, respectively). The most common causes of head injury were (1) Struck by an Object (24.9%) and (2) Falling on the Same Level (22.8%). Falling from a Transport was the only etiological code significantly associated with concussion symptoms after head injury (RC: 28.7%, p<.001). Results were similar when using the two coding structures in combination. Prevention efforts should focus on activities where children are moving at high speeds since these are more likely to cause a concussion when a head injury occurs.

Keywords: Concussion, sports, ICECI, ICD-10

DOI: 10.3233/NRE-2007-22305

Journal: NeuroRehabilitation, vol. 22, no. 3, pp. 191-198, 2007