{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:49:34Z","timestamp":1777880974041,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Sports-related concussions are a public health crisis of serious concern among youth athletes. Loss of consciousness (LOC) is a particularly concerning sequela of concussions, causing detrimental long-term effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To utilize National Electronic Injury Surveillance System (NEISS) data from 2014 to 2023 to track the incidence of LOC and concussions in youth athletes ages 4 to 13 years in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Descriptive epidemiology study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>NEISS search criteria were entered filtering all concussions and LOC in children ages 4 to 13 years from the years 2014 to 2023 who were filed under the sport tags of football, basketball, baseball, softball, soccer, gymnastics, hockey, wrestling, and lacrosse. Linear regression, analysis of variance (ANOVA), and proportion tests were utilized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In total, 554 (6.30% of 8828) concussions resulted in LOC in the entire 2014-2023 cohort (excluding 2020-2021). The frequency of players experiencing LOC from 2014 to 2023 showed an overall downward trend, with a trendline\n                      <jats:italic toggle=\"yes\">R<\/jats:italic>\n                      value of 0.9114. Football, basketball, soccer, and baseball were the top 4 LOC-producing sports (n = 9) from 2014 to 2023. ANOVA single-factor analysis produced a\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value of .0069 between the sports. Wrestling reported the highest overall rate of LOC per concussion from 2014 to 2023, with 24 reported incidences of LOC compared with 216 reported concussions (11.11%). Proportion test analysis of wrestling indicated a statistically significant difference from the mean of the other sports (6.0%) through the years 2014-2023 with a\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value of .0059.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The results of this study show a decrease in the overall level of LOC incidence in US youth athletes ages 4 to 13 years from 2014 to 2023 across 8 sports. The data delineate from previous studies that show an exponential increase in LOC incidence; however, the underlying reasons are still unclear and warrant further investigation. Further investigation into the reasoning behind these epidemiological trends could help build an understanding of these findings and reduce the injury burden on youth athletes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671251353761","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T12:43:06Z","timestamp":1754311386000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Youth Ages 4 to 13 Trends of Sports Concussions With Loss of Consciousness From 2014-2023 National Electronic Injury Surveillance System"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6626-5456","authenticated-orcid":false,"given":"Steven P.","family":"Gawrys","sequence":"first","affiliation":[{"name":"Department of Community Health &amp; Family Medicine, University of Florida Health, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. Tanner","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Community Health &amp; Family Medicine, University of Florida Health, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dillon C.","family":"Reno","sequence":"additional","affiliation":[{"name":"Department of Community Health &amp; Family Medicine, University of Florida Health, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew S.","family":"Jorgensen","sequence":"additional","affiliation":[{"name":"Department of Community Health &amp; Family Medicine, University of Florida Health, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"Arch G.","family":"Mainous","sequence":"additional","affiliation":[{"name":"Department of Community Health &amp; Family Medicine, University of Florida Health, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Community Health &amp; Family Medicine, University of Florida Health, Gainesville, Florida, USA"},{"name":"Department of Orthopedic Surgery and Sports Medicine, University of Florida Health, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.23.00025"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2018.09.040"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967114528460"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1941738120932570"},{"key":"e_1_3_3_6_2","unstructured":"Concussion. University of Michigan Health. Accessed August 31 2024. https:\/\/www.uofmhealth.org\/conditions-treatments\/pediatric-brain-neurological\/brain-neurological-conditions\/concussion"},{"key":"e_1_3_3_7_2","unstructured":"Concussion Handout for Sport Club Participants With a Suspected Concussion. Accessed August 31 2024. https:\/\/www.uwlax.edu\/globalassets\/offices-services\/recsports\/sport-clubs\/pdf\/sport-club-concussion-information-handout.pdf"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsams.2022.07.005"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2021-104519"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2018-100338"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097729"},{"key":"e_1_3_3_12_2","doi-asserted-by":"crossref","unstructured":"Jo J Williams KL Wallace J et al. 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