103 The epidemiology of traumatic brain injuries within USA Fencing, 2015–2020: prevention, care, and return to play considerations

Abstract

<h3>Background</h3> Mild traumatic brain injury (mTBI) is an increasing sports-related and public health concern affecting millions annually. While competitive fencing has been identified as a safe sport with a low occurrence of sport related injury, prevention, care, and return to play considerations from a mTBI is a persisting issue due to sport related factors. <h3>Objective</h3> To identify incidence and prevalence of mTBI over 5 competitive fencing seasons through a Sport Event Medical Encounter System (SEMES). <h3>Design</h3> Documented mTBI sustained at USA Fencing sponsored domestic events and individual and national team involvement at international events were analyzed from the 2015–2020 competitive seasons. <h3>Setting</h3> All SEMES mTBI data collected at USA Fencing sponsored domestic fencing events involving Y14 through veteran competitors as well as individual and national team involvement at international events were included in the analysis. <h3>Patients (or Participants)</h3> Inclusion criteria involved both genders within the competition categories of Y14 through veteran divisions. Among 98,000 fencing competitors, 75 sustained a mTBI requiring medical withdrawal. <h3>Interventions (or Assessment of Risk Factors)</h3> USA Fencing has an annual competitive growth of 5% over the past five seasons. Increased staffing of credentialed sports medicine clinicians at domestic and international events to recognize and document mTBI. <h3>Main Outcome Measurements</h3> Improved documentation of mTBI to influence prevention, care, and return to play interventions. <h3>Results</h3> Data identified two primary mechanisms of injury leading to diagnosed mTBI: indirect head trauma from a blow to the mask from an opponent’s weapon guard and falling backwards onto the strip causing direct posterior trauma to the head. The acceleration-deceleration mechanism of injury (whiplash) was also a component in both of these identified injury mechanisms. <h3>Conclusions</h3> Increased clinician staffing at domestic and international events has directly correlated with an increase in documentation and overall mTBI prevention, diagnosis, care, and return to play considerations.