Incidence of Combat Sport-Related Mild Traumatic Brain Injuries Presenting to the Emergency Department From 2012 to 2016

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We sought to investigate the incidence and characteristics of traumatic brain injuries [mild traumatic brain injury (MTBI)] presenting to the emergency department as a result of boxing, wrestling, and martial arts (MA).


Retrospective cross-sectional study of MTBI in combat sport athletes who were evaluated in emergency departments in the United States.


Patient data were taken from the National Electronic Injury Surveillance System.


All patients with MTBI from 2012 to 2016, which occurred during participation in boxing, MA, or wrestling.



Main Outcome Measures:

The incidence of combat sport-related MTBI presenting to emergency departments in the United States.


The mean annual incidence of MTBI due to wrestling was significantly larger (269.3 per 100 000 person-years) than boxing (85.6 per 100 000 person-years) and MA (61.0 per 100 000 person-years) (P < 0.01). The average age at injury was significantly lower for wrestling compared with boxing and MA (15.0 years [SD ± 3.9] vs 21.7 years [SD ± 8.2] vs 19.9 years [SD ± 10.5]; P < 0.01). A significantly larger proportion of MTBIs (95.3%; P < 0.01) in patients younger than 20 years were related to wrestling, compared with boxing (55.8%) and MA (54.1%). Most patients with combat sport-related MTBIs were treated and discharged (96.3%), with only 1.7% of patients being admitted and 0.6% of patients being held for observation.


Combat sports athletes are at high risk of sustaining an MTBI. Such athletes presenting to the emergency department for combat sport-related MTBI were more likely to be male and younger than 20 years. Of these athletes, wrestlers experience the highest incidence of MTBI-related emergency department visits.

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