12.11 Clinical and financial implications of concussive injuries sustained in U.S. rugby-7s

Abstract

<h3>Objective</h3> To investigate the medical diagnosis and procedural coding cost of concussions in U.S. rugby-7s. <h3>Design</h3> Prospective descriptive epidemiological study. <h3>Setting</h3> USA Rugby rugby-7s geographic union tournament series (79 tournament-days, 2010–2015). <h3>Participants</h3> Tournament players (n=164; female=27%; male=73%) sustaining acute head injuries during matches in the <i>RISE</i>Rugby Injury Registry. <h3>Assessment of Risk Factors</h3> Injury diagnosis and medical billing coding for concussion diagnosis, and the financial cost of tournament-treatment interventions. <h3>Outcome Measures</h3> International Classification of Diseases, Tenth Revision (ICD-10) and Current Procedural Terminology (CPT) were computed after player concussion injury encounters. Financial cost (US$=dollars) was calculated after initial encounter, evaluation/recommendation for further treatment and follow-up were made for each player. <h3>Main Results</h3> Tournament series encountered head injuries (15.1%; n=164) most often coded as a wound and/or laceration (74%), followed by fractures (9%). Costs were most often in the form of sideline evaluation, first aid/wound care, ice/compression, and post-match cephalic imaging (n=153). Meanwhile, 13.4% (n=22; male=15, female=7) of all head injuries which were coded by the ICD-10 system as an acute concussive injury without any additional co-diagnosis. Concussions at 18.2% (n=4) needed hospitalization and further imaging studies. The total estimated direct medical costs of concussive injuries was US$4,332 (US$197 per player concussion). <h3>Conclusions</h3> Head injuries were common in our US Rugby-7s cohort, with men being treated for concussions more than women players. Concussed players needing higher institutional care supports tournaments series will need quality acute sideline treatment to address these injuries.

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