172 - Head Games: Analyzing Sports that Seek Specialty Care for Concussion Management

Publication Number: 1161.172

Andrea M. Zeebe, Tulane University, Honolulu, HI, United States; Jennifer R. King, Hawaii Pacific Health Medical Group, HONOLULU, HI, United States; Andrea Siu, Hawaii Pacific Health, Honolulu, HI, United States

Background: Although sport-specific concussion incidence and management in Hawai'i are well documented through programs like the Hawai'i Concussion Awareness Program (HCAMP), less is known about how many athletes seek care from concussion specialists trained in the management of sports-related concussions. In Hawai'i, the Kapi'olani Pediatric and Adolescent Concussion Clinic is the only clinic specializing in concussion care for high school athletes.

Objective: This project examined referrals to the Kapi'olani Concussion Clinic to characterize referral patterns by sport and identify potential disparities in access to care.

Design/Methods: This cross-sectional, descriptive study reviewed 2,225 concussion cases from the Kapiʻolani Concussion Clinic (median age = 15 years) to characterize the overall clinic population. We were also provided with limited high school concussion data from the Hawai'i Department of Education (DOE) (n=822) to compare to patients seen by the Kapi'olani Concussion Clinic. After excluding non-sport-related cases, visits outside of the 2021-2023 academic years, and athletes outside the DOE's scope, including those from elementary, middle, and private schools or sports not tracked by the DOE, we identified 90 high school athletes seen between 2021 and 2023 to compare to the concussion data provided by the DOE. A two-sample test of proportions was used to evaluate the equivalence between the two sets of data.

Results: We found that no sport was significantly over or underrepresented in referrals when comparing concussion rates by sport and gender, suggesting that care is consistent across sports (p-values: baseball = 0.05, basketball = 1.00, cheerleading = 0.11, football = 0.25, judo = 0.77, soccer = 0.43, softball = 0.24, volleyball = 0.15, wrestling = 0.27).

Conclusion(s): Our findings indicate that the percentage of athletes receiving specialized care for sports-related concussions is consistent across all sports in Hawai'i, as no sport showed a significant difference in concussion referral rates (all p-values > 0.05). This finding may be due to HCAMP's efforts to improve statewide concussion care through legislation and outreach.

Concussion Rate by Sport
This chart presents concussion rates across 9 public school sports, comparing the 90 Kapi'olani Concussion Clinic cases to the 822 DOE-reported cases. Concussion rates were calculated by dividing the number of concussions in each sport by the total number of concussions in that dataset. None of the differences were statistically significant (p >0.05).


Concussion Rate by Sport and Gender
This chart compares concussion rates across boys' and girls' sports using data from Kapi'olani Concussion Clinic referrals and Hawai'i DOE reports (2021-2023). None of the differences were statistically significant (p > 0.05), indicating consistent referral patterns across genders.