Sport Participation Among Children With Complicated Mild Traumatic Brain Injury.

INTRODUCTION
Complicated mild traumatic brain injury (C-mTBI) represents mTBI with positive trauma-related radiographic findings, such as hematoma. It is estimated that 7.5% of all pediatric mTBIs meet these criteria. There is a paucity of research on return to sports in children with C-mTBI.


OBJECTIVE
To examine children with C-mTBI, mTBI with skull fracture only (mTBI-SF) and mTBI in relation to sport participation and factors associated with repeat injury.


DESIGN
Cross-sectional survey.


SETTING
Level I pediatric trauma center.


PARTICIPANTS
Parents of children who were 5-18 years of age at the time of injury who sustained C-mTBI or mTBI from 2010-2013.


INTERVENTIONS
Not applicable MAIN OUTCOME MEASURES: Sports participation characteristics before and after injury in children with C-mTBI and mTBI as a function of degree and length of recovery. Repeat mTBI after the index injury was also examined.


RESULTS
Of 247 children who participated in sports pre-injury (27.5% with C-mTBI and 9.7% with mTBI-SF), 95.1% returned to sports. There was no significant difference by mTBI type regarding participation in any sports (p = 0.811), nor with high risk sports (p = 0.128). C-mTBI, but not mTBI-SF (versus mTBI) was associated with lower odds of sustaining a repeat mTBI (odds ratio = 0.30, p = 0.045). Waiting longer (> 3 months compared to < 1 month) to return to contact sports was associated with lower odds of sustaining a repeat mTBI (odds ratio = 0.23, p < 0.05).


CONCLUSIONS
Children with C-mTBI and mTBI-SF resume similar sports as children with mTBI. Those with C-mTBI and those who take longer to return to play may have lower risk of repeat mTBIs. Prospective research is needed to inform the development of evidence-based guidelines for children with C-mTBI and mTBI-SF.