A five-year clinical audit of concussive injuries in South African collegiate male rugby players—a South African experience

Abstract

Sports-related concussion (SRC) is a common injury mostly in contact sports. Specifically, it is a public health concern for collegiate rugby athletes because at least one concussion is reported in every two games and concussion has been reported to increase the risk of developing neuro-degenerative disorders later in life. To clinically audit concussions to examine commonly reported signs/symptoms in the Sports Concussion Assessment Tool (SCAT). Retrospective audit of a South African University health services medical electronic records database for all concussion International Classification of Diseases 10 (ICD10) diagnoses codes: S06.0, S06.00 and S06.01 in 367 rugby players (age 24.6 ± 4.3, height 1.8 ± 0.1 and weight; 90.7 ± 14.4) for the period 2013–2018. SCAT data was obtained for 70% of the 434 concussions. Headache (57%), “pressure in head” (56%), feeling slowed down (55%) and fatigue/low energy (54%) were the most frequently reported concussion symptoms on the SCAT. A significant reduction in the serial SCAT symptom (p < 0.001) and severity (p < 0.001) scores was observed in a sub-set of the rugby players. The concussion incidence proportion was 7%; this was obtained from an annual estimate of the University rugby club’s registered players and concussion count (n = 87) during the five-year period. The initial SCAT sub-domain scores following a SRC in this collegiate cohort were consistent with other elite adult male sport cohorts in endorsing many symptoms and showing low-concentration scores. A unique feature of this study was the tracking of serial symptoms in a sub-set of this cohort. These players showed a clear reduction in symptom endorsement, but were still not symptom-free by their third SCAT. The collegiate student population should be educated regarding symptoms, including headache, which might be indicative of concussion following a head injury.