Rugby Union Concussions-recognize And Rugby Union Concussions-recognise Andremove:do We Over-call Suspected Concussions?

Abstract

PURPOSE: To determine if the World Rugby (WR) management guidelines of recognize and remove suspected concussions could lead to over-recognition of suspected concussion METHODS: RESULTS: A retrospective analysis of head injuries in a cohort of Stellenbosch University collegiate rugby players (n = 407), age (mean ± SD; 24.6±4.3), height (mean ± SD; 1.83±0.07), weight (mean ± SD; 90.7±14.4) and BMI (mean ± SD; 26.5±5.7) for the period 2014-2018. All 407 players were removed from the field of play upon suspicion of a concussion according to World Rugby’s “recognize and remove” guidelines. Indicators that a player might be concussed on the “recognize and remove” guidelines include seizure, loss of consciousness, confused, dazed, balance problems and behavioral changes. Each of the players with a suspected concussion returned for a clinical assessment performed using the Sports Concussion Assessment Tool (SCAT)-3 (n = 362) and/or SCAT-5 (n = 45) within 48 hours and was subsequently clinically diagnosed with or without a concussion by a qualified medical doctor. The SCAT questionnaire includes questions on red flags, mechanism of injury, symptom severity -, cognitive- and physical-evaluation, and neck examination, balance, and standardized assessment of concussion (SAC) delayed recall and concussion injury advice. Out of the 407 suspected concussions, 90% were confirmed clinically within a 48 hours period, while 10% of suspected concussions were not clinically confirmed as a concussion. In addition, of the reported mechanism of injury (n = 300) the tackle was reported as the main mechanism of injury, accounting for over 70% of all concussion injuries. CONCLUSIONS: It appears that World Rugby’s “recognize and remove” guidelines is accurate in the eventual diagnosis of concussion. Therefore, we are not “over-calling” concussions in collegiate rugby in Stellenbosch. There is also a greater understanding by collegiate rugby medical staff as to how to diagnose and recognize concussion.