Citation

Smoliga JM, Zavorsky GS. Epidemiology 2017; 28(5): 753-757.

Affiliation

1.Department of Physical Therapy, One University Parkway, High Point University, High Point, NC USA 27268 jsmoliga@highpoint.edu 2.Department of Respiratory Therapy, Georgia State University, Georgia State University, P.O. Box 4019, Atlanta, GA USA, 30302-4019 zavorsky@gsu.edu.

Copyright

(Copyright © 2017, Lippincott Williams and Wilkins)

DOI

10.1097/EDE.0000000000000694

PMID

28570384

Abstract

BACKGROUND: Observational research has linked altitude to concussion risk, but the physiologic and epidemiologic bases for this association remain questionable.

METHODS: We performed a retrospective cohort study by analyzing four seasons of NFL data from a widely used database (Concussion Watch) to determine if previous claims that altitude ≥196m reduced concussion risk were replicable and whether an arbitrary predictor variable (animal vs. non-animal team logo) was related to concussion risk. Relative risk (RR) and 95% confidence (95%CI) intervals were computed.

RESULTS: The previous association with altitude was reproduced for earlier seasons, but not replicable for recent seasons (RR=0.92[95%CI=0.70,1.22]). Across four combined seasons, "higher altitude" (RR=0.78[0.64,0.96]) and animal logo (RR=0.75[0.63,0.89]) were similarly associated with reduced concussion risk.

CONCLUSIONS: Inconsistent epidemiologic effects, combined with weak physiologic rationale, suggest links between altitude and concussion are coincidental. Interdisciplinary critique of concussion research is necessary to ensure that marketing claims and clinical recommendations are scientifically justified.

Language: en