@article{ref1,
title="High altitude modulates concussion incidence, severity, and recovery in young athletes",
journal="Brain injury",
year="2022",
author="Li, Adam Y. and Durbin, John R. and Hannah, Theodore C. and Ali, Muhammad and Spiera, Zachary and Marayati, Naoum Fares and Dreher, Nickolas and Schupper, Alexander J. and Kuohn, Lindsey and Gometz, Alex and Lovell, Mark R. and Choudhri, Tanvir F.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: High altitude may affect concussion, but prior studies are limited. We tested whether high altitude affects sport-related concussion (SRC) incidence, severity, and recovery. <br><br>METHODS: Twenty-five thousand eight hundred fifteen baseline and post-injury Immediate Post-Concussion Assessment and Cognitive Testing results were compiled from Florida and Colorado, low (27 m or 62 m) and high (1,640 m or 1,991 m) altitude locations, respectively. Incidence, severity, and recovery of injury were compared between altitudes. <br><br>RESULTS: High altitude was associated with increased suspected concussion incidence (adjusted OR, 2.04 [95% CI, 1.86 to 2.24];P < .0001). However, high altitude was associated with lower concussion severity measured by Severity Index (SI) (adjusted OR, 0.42 [95% CI, 0.37 to 0.49];P < .0001). High altitude was associated with decreased recovery from post-concussive symptoms in the migraine (β, -2.72 [95% CI, -3.31 to -2.13]; P < .0001), cognitive (β, -1.88 [95% CI, -2.40 to -1.36]; P < .0001), and sleep symptom clusters (β, -0.30 [95% CI, -0.52 to -0.08]; P = .007). Athletes with initial SI≥8 showed prolonged neurocognitive dysfunction at high altitude (HR, 1.38 [95% CI, 1.06 to 1.81]; P = .02). <br><br>CONCLUSIONS: High altitude was associated with increased suspected concussions and prolonged recovery but less severe initial injury.<p /> <p>Language: en</p>",
language="en",
issn="0269-9052",
doi="10.1080/02699052.2022.2035435",
url="http://dx.doi.org/10.1080/02699052.2022.2035435"
}