{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:59:29Z","timestamp":1787068769065,"version":"build-2736575974"},"reference-count":30,"publisher":"National Athletic Trainers' Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3]]},"abstract":"\n Context<\/jats:title>\n Concussion research has primarily focused on sport-related mechanisms and excluded non\u2013sport-related mechanisms. In adult populations, non\u2013sport-related concussions (non-SRCs) demonstrated worse clinical outcomes compared with sport-related concussions (SRCs); however, investigations of non-SRCs in college-aged patients are limited.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To examine clinical outcomes in collegiate athletes with non-SRCs compared with SRCs and explore sex differences in outcomes among collegiate athletes with non-SRCs.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Prospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Clinical setting.<\/jats:p>\n <\/jats:sec>\n \n Patients or Other Participants<\/jats:title>\n A total of 3500 athletes were included (n = 555 with non-SRCs, 42.5% female) from colleges or universities and service academies participating in the National Collegiate Athletic Association Department of Defense Concussion Assessment, Research and Education (CARE) Consortium.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measure(s)<\/jats:title>\n \n Dichotomous outcomes (\n yes<\/jats:italic>\n or\n no<\/jats:italic>\n ) consisted of immediate reporting, mental status alterations, loss of consciousness, posttraumatic amnesia, retrograde amnesia, motor impairments, delayed symptom presentation, and required hospital transport. Continuous outcomes were symptom severity, days with concussion symptoms, and days lost to injury. Data were collected within 24 to 48 hours of injury and at return to play. Adjusted relative risks (ARRs) compared the likelihood of dichotomous outcomes by mechanism and by sex within patients with non-SRCs. Multivariate negative binomial regressions were used to assess group differences in continuous variables.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Athletes with non-SRCs were less likely to report immediately (ARR = 0.73, 95% CI = 0.65, 0.81) and more likely to report delayed symptom presentation (ARR = 1.17, 95% CI = 1.03, 1.32), loss of consciousness (ARR = 3.15, 95% CI = 2.32, 4.28), retrograde amnesia (ARR = 1.77, 95% CI = 1.22, 2.57), and motor impairment (ARR = 1.45, 95% CI = 1.14, 1.84). Athletes with non-SRCs described greater symptom severity, more symptomatic days, and more days lost to injury (\n P<\/jats:italic>\n < .001) compared with those who had SRCs. Within the non-SRC group, female athletes indicated greater symptom severity, more symptomatic days, and more days lost to injury (\n P<\/jats:italic>\n < .03) than male athletes.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Athletes with non-SRCs had worse postinjury outcomes compared with those who had SRCs, and female athletes with non-SRCs had worse recovery metrics than male athletes. Our findings suggest that further investigation of individuals with non-SRCs is needed to improve concussion reporting and management.<\/jats:p>\n <\/jats:sec>","DOI":"10.4085\/1062-6050-0181.23","type":"journal-article","created":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T08:01:54Z","timestamp":1694160114000},"page":"289-296","source":"Crossref","is-referenced-by-count":19,"title":["Postinjury Outcomes After Non\u2013Sport-Related Concussion: A CARE Consortium Study"],"prefix":"10.4085","volume":"59","author":[{"given":"Patricia R.","family":"Roby","sequence":"first","affiliation":[{"name":"Center for Injury Research and Prevention, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne E.","family":"Mozel","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Prevention, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristy B.","family":"Arbogast","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Prevention, University of Pennsylvania, Philadelphia"},{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia"},{"name":"Division of Emergency Medicine, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Buckley","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Applied Physiology, University of Delaware, Newark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaclyn B.","family":"Caccese","sequence":"additional","affiliation":[{"name":"School of Health & Rehabilitation Sciences, Ohio State University College of Medicine, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara P. D.","family":"Chrisman","sequence":"additional","affiliation":[{"name":"Center for Child Health, Behavior and Development, Seattle Children\u2019s Research Institute, WA"},{"name":"Division of Adolescent Medicine, Department of Pediatrics, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Clugston","sequence":"additional","affiliation":[{"name":"Departments of Community Health & Family Medicine and Neurology, University of Florida, Gainesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James T.","family":"Eckner","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie","family":"Esopenko","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamerah","family":"Hunt","sequence":"additional","affiliation":[{"name":"Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise A.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Exercise Science, California Lutheran University, Thousand Oaks"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"McDevitt","sequence":"additional","affiliation":[{"name":"Department of Health and Rehabilitation Science, Temple University, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan M.","family":"Perkins","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science, Indiana University, Bloomington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margot","family":"Putukian","sequence":"additional","affiliation":[{"name":"Major League Soccer, Formerly Princeton University, University Health Service, Princeton, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Susmarski","sequence":"additional","affiliation":[{"name":"Loras College, Dubuque, IA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven P.","family":"Broglio","sequence":"additional","affiliation":[{"name":"Concussion Center, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul F.","family":"Pasquina","sequence":"additional","affiliation":[{"name":"Physical Medicine & Rehabilitation, Uniformed Services University, Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas W.","family":"McAllister","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Indiana University School of Medicine, Indianapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"McCrea","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Medical College of Wisconsin, Milwaukee"},{"name":"Departments of Neurology, Medical College of Wisconsin, Milwaukee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina L.","family":"Master","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Prevention, University of Pennsylvania, Philadelphia"},{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia"},{"name":"Sports Medicine Performance Center, Children\u2019s Hospital of Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","reference":[{"key":"i1062-6050-59-3-289-b01","article-title":"Report to Congress on traumatic brain injury in the United States: epidemiology and rehabilitation","year":"2015","unstructured":"Report to Congress on traumatic brain injury in the United States: epidemiology and rehabilitation. 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MMWR Morb Mortal Wkly Rep. 2021;70(48):1664\u20131668. doi:10.15585\/mmwr.mm7048a3"},{"issue":"3","key":"i1062-6050-59-3-289-b03","series-title":"J Head Trauma Rehabil","first-page":"185","article-title":"Trends in sports- and recreation-related traumatic brain injuries treated in US emergency departments: the National Electronic Injury Surveillance System-All Injury Program (NEI\\SS-AIP) 2001\u20132012","volume":"30","author":"Coronado","year":"2015","unstructured":"Coronado\n VG,\n \n \n Haileyesus\n T,\n \n \n Cheng\n TA,\n \n et al.\n \n Trends in sports- and recreation-related traumatic brain injuries treated in US emergency departments: the National Electronic Injury Surveillance System-All Injury Program (NEI\\SS-AIP) 2001\u20132012. 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Differences in sport-related concussion for female and male athletes in comparable collegiate sports: a study from the NCAA-DoD Concussion Assessment, Research and Education (CARE) Consortium","volume":"55","author":"Master","year":"2021","unstructured":"Master\n CL,\n \n \n Katz\n BP,\n \n \n Arbogast\n KB,\n \n et al.\n ; CARE Consortium Investigators. Differences in sport-related concussion for female and male athletes in comparable collegiate sports: a study from the NCAA-DoD Concussion Assessment, Research and Education (CARE) Consortium. Br J Sports Med. 2021;55(24):1387\u20131394. doi:10.1136\/bjsports-2020-103316"},{"key":"i1062-6050-59-3-289-b08","series-title":"J Neurol Sci","first-page":"312","article-title":"Rapid sideline performance meets outpatient clinic: results from a multidisciplinary concussion center registry","volume":"379","author":"Kyle Harrold","year":"2017","unstructured":"Kyle Harrold\n G,\n \n \n Hasanaj\n L,\n \n \n Moehringer\n N,\n \n et al.\n \n Rapid sideline performance meets outpatient clinic: results from a multidisciplinary concussion center registry. 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J Sch Health. 2022;92(4):406\u2013417. doi:10.1111\/josh.13140"},{"issue":"7","key":"i1062-6050-59-3-289-b10","series-title":"Sport Med","first-page":"1437","article-title":"A national study on the effects of concussion in collegiate athletes and US Military Service Academy members: the NCAA\u2013DoD Concussion Assessment, Research and Education (CARE) Consortium structure and methods","volume":"47","author":"Broglio","year":"2017","unstructured":"Broglio\n SP,\n \n \n McCrea\n M,\n \n \n McAllister\n T,\n \n et al.; CARE Consortium Investigators. A national study on the effects of concussion in collegiate athletes and US Military Service Academy members: the NCAA\u2013DoD Concussion Assessment, Research and Education (CARE) Consortium structure and methods. Sport Med. 2017;47(7):1437\u20131451. doi:10.1007\/s40279-017-0707-1"},{"issue":"suppl 1","key":"i1062-6050-59-3-289-b11","series-title":"Neurosurgery","first-page":"S3","article-title":"Concussion guidelines step 1: systematic review of prevalent indicators","volume":"75","author":"Carney","year":"2014","unstructured":"Carney\n N,\n \n \n Ghajar\n J,\n \n \n Jagoda\n A,\n \n et al.\n \n Concussion guidelines step 1: systematic review of prevalent indicators. Neurosurgery. 2014;75(suppl 1):S3\u2013S15. doi:10.1227\/NEU.0000000000000433"},{"issue":"4","key":"i1062-6050-59-3-289-b12","series-title":"Pediatrics","first-page":"841","article-title":"Medical conditions affecting sports participation","volume":"121","author":"Rice","year":"2008","unstructured":"Rice\n SG;\n \n American Academy of Pediatrics Council on Sports Medicine and Fitness.\n \n Medical conditions affecting sports participation. 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J Emerg Med. 2020;59(6):795\u2013804. doi:10.1016\/j.jemermed.2020.09.017"},{"issue":"12","key":"i1062-6050-59-3-289-b17","series-title":"Am J Emerg Med","first-page":"2144","article-title":"Concussion diagnoses among adults presenting to three Canadian emergency departments: missed opportunities","volume":"36","author":"Rowe","year":"2018","unstructured":"Rowe\n BH,\n \n \n Eliyahu\n L,\n \n \n Lowes\n J,\n \n et al.\n \n Concussion diagnoses among adults presenting to three Canadian emergency departments: missed opportunities. Am J Emerg Med. 2018;36(12):2144\u20132151. doi:10.1016\/j.ajem.2018.03.040"},{"issue":"3","key":"i1062-6050-59-3-289-b18","series-title":"J Head Trauma Rehabil","first-page":"E52","article-title":"Does mechanism of injury play a role in recovery from concussion","volume":"30","author":"Seiger","year":"2015","unstructured":"Seiger\n A,\n \n \n Goldwater\n E,\n \n \n Deibert\n E.\n \n \n Does mechanism of injury play a role in recovery from concussion? J Head Trauma Rehabil. 2015;30(3):E52\u2013E56. doi:10.1097\/HTR.0000000000000051"},{"issue":"14","key":"i1062-6050-59-3-289-b19","series-title":"Clin Pediatr (Phila)","first-page":"1280","article-title":"Sleep disturbance following concussion is a risk factor for a prolonged recovery","volume":"56","author":"Bramley","year":"2017","unstructured":"Bramley\n H,\n \n \n Henson\n A,\n \n \n Lewis\n MM,\n \n \n Kong\n L,\n \n \n Stetter\n C,\n \n \n Silvis\n M.\n \n \n Sleep disturbance following concussion is a risk factor for a prolonged recovery. 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Can J Neurol Sci. 2018;45(6):636\u2013642. doi:10.1017\/cjn.2018.322"},{"issue":"7","key":"i1062-6050-59-3-289-b21","series-title":"Sports Med","first-page":"1491","article-title":"The influence of timing of reporting and clinic presentation on concussion recovery outcomes: a systematic review and meta-analysis","volume":"51","author":"Barnhart","year":"2021","unstructured":"Barnhart\n M,\n \n \n Bay\n RC,\n \n \n Valovich McLeod\n TC.\n \n \n The influence of timing of reporting and clinic presentation on concussion recovery outcomes: a systematic review and meta-analysis. Sports Med. 2021;51(7):1491\u20131508. doi:10.1007\/s40279-021-01444-7"},{"issue":"6","key":"i1062-6050-59-3-289-b22","series-title":"Am J Sports Med","first-page":"1465","article-title":"Immediate removal from activity after sport-related concussion is associated with shorter clinical recovery and less severe symptoms in collegiate student-athletes","volume":"46","author":"Asken","year":"2018","unstructured":"Asken\n BM,\n \n \n Bauer\n RM,\n \n \n Guskiewicz\n KM,\n \n et al.\n \n Immediate removal from activity after sport-related concussion is associated with shorter clinical recovery and less severe symptoms in collegiate student-athletes. 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Br J Sports Med. 2017;51(11):838\u2013847. doi:10.1136\/bjsports-2017-097699"},{"issue":"8","key":"i1062-6050-59-3-289-b24","series-title":"Clin Pediatr (Phila)","first-page":"771","article-title":"Gender differences in recovery from sports-related concussion in adolescents","volume":"55","author":"Baker","year":"2016","unstructured":"Baker\n JG,\n \n \n Leddy\n JJ,\n \n \n Darling\n SR,\n \n \n Shucard\n J,\n \n \n Makdissi\n M,\n \n \n Willer\n BS.\n \n \n Gender differences in recovery from sports-related concussion in adolescents. 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Phys Sportsmed. 2013;41(2):58\u201363. doi:10.3810\/psm.2013.05.2015"},{"issue":"5","key":"i1062-6050-59-3-289-b26","series-title":"Clin J Sport Med","first-page":"361","article-title":"Factors affecting recovery trajectories in pediatric female concussion","volume":"29","author":"Desai","year":"2019","unstructured":"Desai\n N,\n \n \n Wiebe\n DJ,\n \n \n Corwin\n DJ,\n \n \n Lockyer\n JE,\n \n \n Grady\n MF,\n \n \n Master\n CL.\n \n \n Factors affecting recovery trajectories in pediatric female concussion. Clin J Sport Med. 2019;29(5):361\u2013367. doi:10.1097\/JSM.0000000000000646"},{"issue":"11","key":"i1062-6050-59-3-289-b27","first-page":"1242","article-title":"The effects of sex differences and hormonal contraception on outcomes following collegiate sports-related concussion","volume":"35","author":"Gallagher","year":"2018","unstructured":"Gallagher\n V,\n \n \n Kramer\n N,\n \n \n Abbott\n K,\n \n et al.\n \n The effects of sex differences and hormonal contraception on outcomes following collegiate sports-related concussion. 2018;35(11):1242\u20131247. doi:10.1089\/neu.2017.5453"},{"issue":"1","key":"i1062-6050-59-3-289-b28","first-page":"99","article-title":"National Athletic Trainers\u2019 Association position statement: emergency planning in athletics","volume":"37","author":"Andersen","year":"2002","unstructured":"Andersen\n JC,\n \n \n Courson\n RW,\n \n \n Kleiner\n DM,\n \n \n Mcloda\n TA.\n \n \n National Athletic Trainers\u2019 Association position statement: emergency planning in athletics. 2002;37(1):99\u2013104."},{"issue":"2","key":"i1062-6050-59-3-289-b29","series-title":"J Law, Med Ethics","first-page":"307","article-title":"Trust, conflicts of interest, and concussion reporting in college football players","volume":"48","author":"Baugh","year":"2020","unstructured":"Baugh\n CM,\n \n \n Kroshus\n E,\n \n \n Meehan\n WP,\n \n \n Campbell\n EG.\n \n \n Trust, conflicts of interest, and concussion reporting in college football players. J Law, Med Ethics. 2020;48(2):307\u2013314. doi:10.1177\/1073110520935342"},{"issue":"5","key":"i1062-6050-59-3-289-b30","series-title":"Brain Inj","first-page":"592","article-title":"Collegiate student-athlete sex, years of sport eligibility completed, and sport contact level influence on concussion reporting intentions and behaviours","volume":"33","author":"Weber","year":"2019","unstructured":"Weber\n ML,\n \n \n Suggs\n DW,\n \n \n Bierema\n L,\n \n \n Miller\n LS,\n \n \n Reifsteck\n F,\n \n \n Schmidt\n JD.\n \n \n Collegiate student-athlete sex, years of sport eligibility completed, and sport contact level influence on concussion reporting intentions and behaviours. 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