NCAA DOD CARE Consortium Update 2017 John P. DiFiori, MD Professor and Chief, Division of Sports Medicine and Non-Operative Orthopaedics Head Team Physician, University of California, Los Angeles NBA Director of Sports Medicine
Concussion and the Media
Fewer kids playing youth football as parents concerns grow By DREW BONIFAT Monday, January 11, 2016 More and more with each passing year, Concord Capitols President Ray Raimo has potential football players walk up to him, each delivering the same bad news. We ve had numerous kids come up to us, they show up at sign-ups and say, I d really like to play football, but my mom won t let me, Raimo said. She s afraid I m going to be brain-damaged.
Overview NCAA DOD CARE Consortium Concussion Assessment, Research and Education
NCAA-DOD CARE Consortium
Executive Committee Rauch (DoD), Hack & Hainline (NCAA), Koroshetz (NIH) Concussion Research Initiative Scientific Advisory Panel Iverson, Jordan, Kelly, Marshall, Saykin, Smith, Talavage, Wallace, Xu Consortium Operating Committee Anderson, Broglio (co-chair), Clugston, Duma, Giza, Guskiewicz, McAllister (co-chair), McCrea (co-chair), McGinty, Putukian Publications Committee Broglio, Brooks, Eckner, Katz, McAllister, McCrea, Schmidt, Svoboda Longitudinal Clinical Study Coordinating Center: U of Michigan Broglio (copi) Longitudinal Clinical Study Core (CSC) Administrative Coordinating Center: Indiana U School of Medicine McAllister (copi) Advanced Research Coordinating Center: Medical College of Wisconsin McCrea (copi) Advanced Research Core (ARC) U Oklahoma (BIG12) Anderson U Delaware (Colonial) Buckley & Kaminski Humboldt State (California) Ortega US Coast Guard Academy (New England) O Donnell US Air Force Academy (Mountain West) McGinty & Campbell US Naval Academy (Patriot) Pecina US Military Academy (Patriot) Svoboda California Lutheran (Southern California) Davis U Georgia (SEC) Schmidt U Florida (SEC) Clugston Virginia Tech (ACC) Duma & Rowson U North Carolina (ACC) Guskiewicz & Mihalik U Pittsburgh (ACC) Kontos & Collins Azusa Pacific (Pacific West) Hoy Indiana U (BIG10) Hipskind & Port U Michigan (BIG10) Eckner U Wisconsin (BIG10) Brooks Princeton (Ivy) Putukian UCLA (PAC12) Giza & DiFiori Washington (PAC12) Chrisman U Rochester (University) Bazarian Bloomsburg U (Pennsylvania) Hazzard Temple U (American) Langford U Chicago (University) Benjamin U Miami (ACC) Feigenbaum U North Georgia (Peach Belt) Miles U Pennsylvania (Ivy) Master Wake Forest U (ACC) Miles Wilmington College (Ohio) Dykhuizen Winston-Salem State U (Central) Lintner NCAA-DOD Grand Alliance CARE Consortium
Clinical Study Core Timeline
Data extracted in Dec 2016 28,421 enrolled 27,023 unique participant baselines 12,479 repeat baselines (2nd year) 1632 concussions All Data is Preliminary
Concussions by Sport Category NCAA Competition Training Non-Sport Related Contact and collision 29 % 65 % 5 % Contact 31 43 26 Non-Contact 2 44 54 Total 24 55 20
Concussion Incidence Rates/10,000 AE Sport Rate Wrestling 10.9 M Ice Hockey 7.9 W ice Hockey 7.5 W Basketball 6.8 Football 6.7 W Soccer 6.3 W Lacrosse 5.2 M Basketball 3.9 Zuckerman SL et al 2015 Am J Sports Med
Concussion Distribution for Contact and Collision Sports Sport % of Athletes with Concussion Ice Hockey 5.7 Football 5.4 Lacrosse 5.4 Soccer 4.8 Field Hockey 4.4 Wrestling 3.6
Concussions Distribution for Sport Contact Sports % of Athletes with Concussion Diving 8.1 Water Polo 7.8 Basketball 5.9 Gymnastics 5.4 Softball 3.1
Concussions by Mechanism NCAA Player to Player Player to ground Equipment related Contact and collision 84 % 13 % 3 % Contact 25 62 13 Non-Contact 12 83 5
Delayed Symptom Onset is Common Symptom Onset Immediate 31% Delayed 65% Median time to sx onset (if not immediate) 60 min (20-150min)
Time to Return to Play Days Overall average RTP 14.3 Symptom duration 6.6 RTP progression 7.7
Time to Return To Play Days % RTP < = 7 14.9 8-14 33.5 15-21 20.4 22-28 9.7 >28 21.6
Delay in Removal from Play after Injury Affects RTP Days for RTP Not Immediately Removed (% RTP) N=422 <=7 13.6 19.4 8-14 34.8 38.0 15-21 21.7 17.5 22-28 9.3 8.0 >28 20.6 17.1 Immediately Removed (% RTP) N=537
Advanced Research Core Timeline
Advanced Research Core 1475 enrolled 110 concussions 345 Football enrollees with instrumented helmets 27 concussions Analysis ongoing wrt relationship between linear and rotational forces and injury
Advanced Research Core Significant reduction in cerebral blood flow in first 48 hours Changes correlate with symptoms and impairment Blood biomarker evaluation ongoing
ARC: Blood Bio-markers Others: TBD
CARE Website
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