Epidemiology of Concussions in High School Boys' Ice Hockey, 2008/09 to 2016/17 School Years

Objective:This study examined the epidemiology of concussions in high school boys' ice hockey during the 2008/09 to 2016/17 school years. Design:Prospective cohort study. Athletic trainers from an average 33 high schools annually reported boys' ice hockey concussion and athlete-exposure (AE) data for the High School Reporting Information Online system. Setting:Convenience sample of high school boys' ice hockey programs during the 2008/09 to 2016/17 school years. Patients or Other Participants: High school boys' ice hockey players (aged similar to 14-18 years). Independent Variables:Concussion data on event type, injury mechanism, symptom resolution time, and time loss were obtained. Main Outcome Measures:Concussion rates with 95% confidence intervals (CIs) and distributions were calculated. Results:Overall, 348 concussions were reported in boys' ice hockey during the 2008/09 to 2016/17 academic years, leading to a concussion rate of 0.68/1000 AEs (95% CI, 0.61-0.75). Most occurred in competitions (85.6%), particularly after the first period (72.1% of all competition concussions). Among practice concussions, most occurred after the first hour of practice (60.0%). Most concussions were due to player contact (47.7%) and boards/glass contact (31.9%). Although 69.0% of concussed athletes had symptoms resolve in less than 7 days, only 14.1% returned to activity within a week. Conclusions: Most concussions occurred within the second and third periods. Preventive strategies that counter an increased risk of concussion due to a greater intensity of gameplay coupled with increased fatigue may be warranted. Moreover, athletes may further benefit from prevention efforts that focus on anticipating impacts during gameplay.