The epidemiology of concussion in professional rugby union in Ireland

Objectives: To determine incidence rates, severity and the nature of concussion in professional rugby union in Ireland. Design: Retrospective observational study of time-loss concussion. Setting: Professional rugby union in Ireland. Participants: 160 male professional rugby union players. Outcome measures: Incidence rates (concussion/1000 player-match-hours) and mean/median severity (days absence) of concussion. Results: This study observed 60 concussions in 47 players over the course of the 2016/17 season. The match concussion incidence rate was 18.4/1000 player-match-hours. Mean and median severity was 12 and 10 days respectively. Overall burden of match concussion was 5 days absence per team per match. Concussion severity (days absence) correlated positively with the number of symptoms (rs 0.32, p = 0.022) and symptom severity score (rs 0.28, p = 0.045) on HIA2/SCAT3 forms. A negative correlation was observed between symptom severity score and the number of days until subsequent injury (rs −0.28, p = 0.049). Tackling was the most common inciting event responsible for concussion. Conclusions: The burden of concussion in professional rugby union is high. Incidence rates appear to be increasing year on year while severity is unchanged. Return to play results in this study highlight the need for caution in concussion recovery and return to play protocols.