Abstract
BackgroundThe objective of this study was to investigate the relationship between engagement in multiple risk behaviours (MRB) and concussion amongst youth.MethodsThis was a cross-sectional study that used survey data collected from 3059 students in grades 6–10 (approximate ages 11–15 years) from Ontario, Canada. Students reported whether or not they had a medically diagnosed concussion within the previous 12 months and the frequency that they participated in several risky behaviours including fighting, bullying, smoking, drinking alcohol, using illicit drugs, drinking caffeinated beverages, not using protective equipment, and having unsafe sex. Responses to the risky behavior items were used to create a MRB score. The association between MRB and concussion was explored using logistic regression that controlled for several confounding variables.ResultsApproximately 10.7% of students reported that they had a medically diagnosed concussion within the past year. A dose-response relationship was found between MRB and concussion among students in grades 9–10, while in grades 6–8 students only those in the highest MRB quartile had an increased likelihood of concussion. The relative odds for concussion in the highest versus the lowest MRB quartile were 4.67 (95% confidence interval: 2.33, 9.35) in grades 9–10 students and 2.94 (95% confidence interval, 1.90, 4.56) in grades 6–8 students.ConclusionsEngagement in MRB may be an important etiologic component of adolescent concussion. Future studies should address whether behavioural interventions designed to decrease engagement in MRB reduce the risk of concussion and other injuries.
Highlights
The objective of this study was to investigate the relationship between engagement in multiple risk behaviours (MRB) and concussion amongst youth
This study provides a novel analysis of the relationship between MRB and concussion
The dose-response relationship between MRB and concussion observed in grade 9–10 students is consistent with previous studies that found dose-response relationships for adolescent injury based on level of engagement in MRB (Koven et al, 2005; Pickett et al, 2002a; Pickett et al, 2002b)
Summary
The objective of this study was to investigate the relationship between engagement in multiple risk behaviours (MRB) and concussion amongst youth. Traumatic brain injury is a major trauma-related cause of death and disability (Rubiano et al, 2015). Most traumatic brain injuries are of a mild severity and are commonly referred to as concussion (Dewan et al, 2018). Adolescents are more sensitive to the neurophysiological consequences of concussions than are adults (Baillargeon et al, 2012). There has been a surge in diagnosed concussion rates. In Canada the annual incidence of medically diagnosed pediatric concussion increased from 34 per 10,000 persons in 2003 to 150 per 10,000 persons in 2013 (Zemek et al, 2017). There has been an increase in research on the physiological
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