The Epidemiology Of Non-time Loss Injuries Predating Subsequent Time-loss Injuries In Collegiate Athletes.

Abstract

Previous injury surveillance studies have failed to describe the association of initial or existing injuries with subsequent, more severe injuries. PURPOSE: This study describes the relationship between injury events within individual athletes where a non-time loss (NTL) injury directly predates a subsequent time loss (TL) injury. METHODS: De-identified data from the National Collegiate Athletic Association Injury Surveillance Program from 2009-2015 were linked by unique student-athlete identifiers. An NTL injury was defined as resulting in time loss <24 hours; TL was defined as time loss ≥24 hours. Multiple injuries in an individual athlete were considered a matched event if each injury had the same values for body part and side, and if the NTL injury preceded the TL injury. Each matched event was then assessed by two athletic trainers to determine if the body structure and diagnosis of the injuries within that matched event indicated that the NTL injury likely contributed to the TL injury. Matched events were categorized as: 1) Direct - the NTL injury directly contributed to the TL injury, 2) Not direct - the NTL injury did not directly contribute to the TL injury, 3) Predisposition - the NTL injury likely made the athlete susceptible to the TL injury, but did not directly contribute to it, 4) Other – the NTL and/or TL diagnosis was reported as “other” and a determination was not possible, and 5) Excluded - events which were either mislabeled or mismatched. Descriptive statistics include counts and percentages. RESULTS: Of 33,203 injuries reported in 15,673 student-athletes, there were 425 matched events which involved 1,117 individual injuries in 387 athletes. Of these 425 matched events, 156 (36.7%) were Direct, 196 (46.1%) were Not direct, 32 (7.5%) were Predisposition, 32 (7.5%) were Other, and 9 (2.1%) were Excluded. Of the Direct events, 52 (33.3%) involved more than two separate injuries to the same body part. CONCLUSION: NTL injuries may potentially contribute to subsequent TL injuries. However, the incidence of such events may be rare, and management of NTL injuries by athletic trainers may mitigate subsequent injury risk. Further research is needed to better estimate the incidence of NTL injuries progressing to TL injuries.