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The proportion of concussions with prolonged recovery was lower among males (IPR of 0.69, 95% CI 0.60\u20130.78), while concussions with altered mental status (IPR of 1.23, 95% CI 1.09\u20131.38), LOC (IPR of 1.67, 95% CI 1.17\u20132.37), PTA (IPR of 1.94, 95% CI 1.43\u20132.62), and RGA (IPR of 2.14, 95% CI 1.38\u20133.31) accounted for a larger proportion among males. A larger proportion of concussions that were immediately reported was observed in males (IPR of 1.15, 95% CI 1.00\u20132.31). Proportions of other characteristics (e.g., recurrent injuries) were not different between sexes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>A higher proportion of concussions occurred outside of sport and military training for female cadets, who also displayed proportionally longer recovery times than males, despite males demonstrating a higher proportion of LOC, PTA, and RGA. Possible factors may include different mechanisms of injury outside of sport and military training, different biopsychosocial states associated with sex or injury context, and delayed injury reporting when outside of an observed environment, possibly secondary to perceived stigma about reporting injuries.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s40279-024-02068-3","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T05:02:04Z","timestamp":1720760524000},"page":"2955-2964","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Sex Differences Across Concussion Characteristics in US Service Academy Cadets: A CARE Consortium Study"],"prefix":"10.1007","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1013-5024","authenticated-orcid":false,"given":"Louise A.","family":"Kelly","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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J Athl Train. 2021;56(3):294\u2013301. https:\/\/doi.org\/10.4085\/1062-6050-0211.20.","journal-title":"J Athl Train"}],"container-title":["Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40279-024-02068-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40279-024-02068-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40279-024-02068-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T21:22:56Z","timestamp":1731532976000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40279-024-02068-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,12]]},"references-count":36,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["2068"],"URL":"https:\/\/doi.org\/10.1007\/s40279-024-02068-3","relation":{},"ISSN":["0112-1642","1179-2035"],"issn-type":[{"value":"0112-1642","type":"print"},{"value":"1179-2035","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,12]]},"assertion":[{"value":"11 June 2024","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 July 2024","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was made possible, in part, with support from the Grand Alliance Concussion Assessment, Research, and Education Consortium, funded by the National Collegiate Athletic Association and the Department of Defense. The US Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick, MD 21702-5014, USA is the awarding and administering acquisition office. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Psychological Health and Traumatic Brain Injury Program under Award no. W81XWH-14-2-0151. Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"J.R.C. receives research support from the National Football League. M.P. is the Chief Medical Officer for Major League Soccer, Senior Advisor National Football League Head, Neck and Spine Committee, Football Association Research Task Force, Concussion in Sport Group Expert Group, National Operating Committee on Standards for Athletic Equipment Scientific Advisory Committee. S.P.B. has current or past research funding from the National Institutes of Health, Centers for Disease Control and Prevention, Department of Defense\u2014USA Medical Research Acquisition Activity, National Collegiate Athletic Association, National Athletic Trainers\u2019 Association Foundation, National Football League, Under Armour, GE, Simbex, and ElmindA. He has consulted for US Soccer, US Cycling, University of Calgary SHRed Concussions external advisory board, and medicolegal litigation. He is coauthor of \u201cBiomechanics of Injury (3rd edition)\u201d and has a patent on \u201cBrain Metabolism Monitoring Through CCO Measurements Using All-Fiber-Integrated Super-Continuum Source\u201d (US 11,529,091 B2). T.W.M. receives grant support for concussion research studies from the NCAA, the US Department of Defense, and the NIH. He also receives royalties for a TBI textbook from American Psychiatric Association Publishing, Inc. M.M. receives research funding to the Medical College of Wisconsin from the National Institutes of Health, Department of Veterans Affairs, Centers for Disease Control and Prevention, Department of Defense, National Collegiate Athletic Association, National Football League, and Abbott Laboratories. He receives book royalties from Oxford University Press. He serves as clinical consultant to Milwaukee Bucks, Milwaukee Brewers, and Green Bay Packers, and is Co-Director of the NFL Neuropsychology Consultants without compensation. He serves as a consultant for Neurotrauma Sciences, Inc. The other authors have no potential conflicts of interest with the content of this article. J.B.C. is an Editorial Board member of Sports Medicine. J.B.C. was not involved in the selection of peer reviewers for the manuscript or any of the subsequent editorial decisions.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of Interest"}},{"value":"Deidentified CARE data can be accessed via the Federal Interagency Traumatic Brain Injury Research database .","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Availability of Data and Materials"}},{"value":"This study was approved by the institutional review board at each study site, in conjunction with approval from the US Army Human Research Protection Office (see also Supplementary Table\u00a01 for ethics approval numbers for individual institutions). This study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"All participants gave written informed consent.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}},{"value":"N\/A.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"N\/A.","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Code Availability"}},{"value":"All authors contributed to the drafting and editing of the manuscript. All authors approved the final manuscript.","order":9,"name":"Ethics","group":{"name":"EthicsHeading","label":"Author Contributions"}}]}}