Sports-related concussions in high school females: an epidemiologic analysis of twenty-year national trends.

The epidemiology of sports-related concussions (SRCs) and closed head injuries (CHIs) in high school females remains undefined at the national level, especially for unorganized sports and recreational activities. This study examines 1,176,092 national weighted estimates of SRCs or CHIs in female patients 14-18 years of age presenting to United States (US) emergency departments (EDs) between 2000 and 2019 in the National Electronic Injury Surveillance System (NEISS). The national weighted estimate of female patients in our study increased significantly (p < 0.001) between 2000 (9,835; 95% Confidence Interval [CI] 7,105-12,566) and 2019 (31,751; CI 26,392-37,110). The top five ranked sports and recreational activities most commonly associated with concussions and CHIs in female patients 14-18 years of age were: soccer (20.6%; CI 17.6%-23.6%); basketball (18.5%; CI 16.9%-20.1%); cheerleading (10.4%; CI 8.9%-11.9%); softball (10.1%; CI 9.0%-11.3%); volleyball (6.5%; CI 5.7%-7.2%). Simple univariate regression models showed that an increase of 10,000 annual female participants across all high school sports and recreational activities was associated with 308.7 (SE = 20.8, p < 0.001, R2 = 0.92) additional annual SRCs and CHIs presenting to US EDs. The promotion of concussion awareness and educational programs may help minimize SRCs and CHIs.