Paediatric Sport‐Related Concussion and Hospitalisation in Australia

Paediatric concussion is very common in Australia, with one in seven children reporting at least one concussion diagnosed by a health professional [1]. Despite the high incidence of sport related concussion (SRC) in Australian children and adolescents, there is a knowledge gap regarding hospital admission in paediatric SRC, including the incidence by sport and sex. We aimed to identify the incidence of hospital admission in paediatric SRC by (i) sport and (ii) sex. The Australian Institute of Health and Welfare (AIHW) [2] recently published a report on ‘Sports Injury in Australia’ [3] which analysed ‘62 100 sports injuries that were serious enough to require a hospital admission in 2023–24’, and excluded those with treatment in the emergency department only, at a General Practice clinic, or by an allied health practitioner (e.g., physiotherapist) [4]. We requested additional data from the AIHW dataset, specifically concussions sustained between the ages of 0–17 years, categorised by sport and sex. The authors self-funded the provision of the additional data. This cross-sectional observational study adheres to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) [5] (see Supporting Information). The authors declare that the research presented in this manuscript adheres to the ethical principles outlined by the Royal Children's Hospital Human Research Ethics Committee. During the 2023–2024 financial year 1380 children and adolescents (0–17 years) were admitted to hospital with SRC (Table 1). The most common sports associated with admission were rugby (union and league) (17.6%), Australian football (14.5%), cycling (13%), soccer (10%), wheeled motor sports (7.8%), basketball (6.9%) and equestrian (4.5%). In male children and adolescents, SRC hospital admission was most commonly associated with rugby (19.1%), cycling (16.6%), Australian football (15.5%), soccer (11.4%), wheeled motor sports (9.1%), basketball (6.7%) and roller sports (4.7%). In female children and adolescents, SRC hospital admission was most commonly associated with Australian football (14.4%), equestrian (14.1%), rugby (13.6%), netball (7.3%), basketball (7.3%), soccer (6.3%), wheeled motor sports (4.4%) and cycling (3.7%). This study has demonstrated that 1380 children and adolescents required hospitalisation in Australia for SRC during 2023–24. There were differences between paediatric male and female admissions, with the most common sports in males being rugby and cycling and in females Australian football and equestrian. These data provide useful information for sporting bodies which may influence preventative and management strategies. It is interesting to note that in the PREDICT study of traumatic brain injury (TBI) [6] the sports most commonly associated with clinically important TBI in children were cycling, skateboarding and horse riding. The decisions to undertake neuroimaging and/or admit a patient after head injury can be difficult in children and adolescents. To assist clinicians with this, the PREDICT paediatric research network with the endorsement of key learned bodies published guidelines for Australia and New Zealand for the management of mild and moderate TBI in children and adolescents, including indications for hospital admission [7]. The AIHW data inform us of the total number of admissions, but do not provide information on the clinical indications for admission. Future studies should examine this to identify compliance with the guidelines, and if not, the skew-direction of non-compliance. More than 1300 children and adolescents with sport related concussion required admission to Australian hospitals, and most commonly participated in rugby, cycling, Australian football, soccer and equestrian sports. There are notable differences in the type of sport associated with concussion between males (rugby and cycling) and females (Australian football and equestrian). Further research is required to identify clinical criteria requiring hospital admission, and implementation of preventive strategies for sporting bodies. No funding was received for this study. The authors self-funded the provision of the additional data from AIHW. All data for this study were obtained from AIHW. The data in Table 1 were supplied by AIHW to the lead author (G.A.D.) specifically for this study. All other data are in the public domain. The authors have nothing to report. The authors declare that the research presented in this manuscript adheres to the ethical principles outlined by the MCRI institutional review board. All procedures involving human participants were conducted in accordance with the ethical standards of the MCRI and the Declaration of Helsinki (1964), as revised in 2013. As all data are in the public domain, ethics committee approval was not required. The authors declare no conflicts of interest. The data that support the findings of this study are available from the corresponding author upon reasonable request. Data S1: jpc70298-sup-0001-STROBE_Checklist.docx. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.