An updated subsequent injury categorisation model (SIC-2.0) : Data-driven categorisation of subsequent injuries in sport
- Authors: Toohey, Liam , Drew, Michael , Fortington, Lauren , Finch, Caroline , Cook, Jill
- Date: 2018
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 48, no. 9 (2018), p. 2199-2210
- Full Text: false
- Reviewed:
- Description: Background: Accounting for subsequent injuries is critical for sports injury epidemiology. The subsequent injury categorisation (SIC-1.0) model was developed to create a framework for accurate categorisation of subsequent injuries but its operationalisation has been challenging. Objectives: The objective of this study was to update the subsequent injury categorisation (SIC-1.0 to SIC-2.0) model to improve its utility and application to sports injury datasets, and to test its applicability to a sports injury dataset. Methods: The SIC-1.0 model was expanded to include two levels of categorisation describing how previous injuries relate to subsequent events. A data-driven classification level was established containing eight discrete injury categories identifiable without clinical input. A sequential classification level that sub-categorised the data-driven categories according to their level of clinical relatedness has 16 distinct subsequent injury types. Manual and automated SIC-2.0 model categorisation were applied to a prospective injury dataset collected for elite rugby sevens players over a 2-year period. Absolute agreement between the two coding methods was assessed. Results: An automated script for automatic data-driven categorisation and a flowchart for manual coding were developed for the SIC-2.0 model. The SIC-2.0 model was applied to 246 injuries sustained by 55 players (median four injuries, range 1–12), 46 (83.6%) of whom experienced more than one injury. The majority of subsequent injuries (78.7%) were sustained to a different site and were of a different nature. Absolute agreement between the manual coding and automated statistical script category allocation was 100%. Conclusions: The updated SIC-2.0 model provides a simple flowchart and automated electronic script to allow both an accurate and efficient method of categorising subsequent injury data in sport.
Is subsequent lower limb injury associated with previous injury? A systematic review and meta-analysis
- Authors: Toohey, Liam , Drew, Michael , Cook, Jill , Finch, Caroline , Gaida, Jamie
- Date: 2017
- Type: Text , Journal article , Review
- Relation: British Journal of Sports Medicine Vol. 51, no. 23 (2017), p. 1670-1678
- Full Text: false
- Reviewed:
- Description: Background Previous injury is a strong risk factor for recurrent lower limb injury in athletic populations, yet the association between previous injury and a subsequent injury different in nature or location is rarely considered. Objective To systematically review data on the risk of sustaining a subsequent lower limb injury different in nature or location following a previous injury. Methods Eight medical databases were searched. Studies were eligible if they reported lower limb injury occurrence following any injury of a different anatomical site and/or of a different nature, assessed injury risk, contained athletic human participants and were written in English. Two reviewers independently applied the eligibility criteria and performed the risk of bias assessment. Meta-analysis was conducted using a random effects model. Results Twelve studies satisfied the eligibility criteria. Previous history of an ACL injury was associated with an increased risk of subsequent hamstring injury (three studies, RR=2.25, 95% CI 1.34 to 3.76), but a history of chronic groin injury was not associated with subsequent hamstring injury (three studies, RR=1.14, 95% CI 0.29 to 4.51). Previous lower limb muscular injury was associated with an increased risk of sustaining a lower limb muscular injury at a different site. A history of concussion and a variety of joint injuries were associated with an increased subsequent lower limb injury risk. Conclusions The fact that previous injury of any type may increase the risk for a range of lower limb subsequent injuries must be considered in the development of future tertiary prevention programmes. Systematic review registration number CRD42016039904 (PROSPERO). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Subsequent injuries are more common than injury recurrences : An analysis of 1 season of prospectively collected injuries in professional Australian football
- Authors: Finch, Caroline , Cook, Jill , Kunstler, Breanne , Akram, Muhammad , Orchard, John
- Date: 2017
- Type: Text , Journal article
- Relation: The American Journal of Sports Medicine Vol. 45, no. 8 (2017), p. 1921-1927
- Full Text: false
- Reviewed:
- Description: BACKGROUND: It is known that some people can, and do, sustain >1 injury over a playing season. However, there is currently little high-quality epidemiological evidence about the risk of, and relationships between, multiple and subsequent injuries. PURPOSE: To describe the subsequent injuries sustained by Australian Football League (AFL) players over 1 season, including their most common injury diagnoses. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Within-player linked injury data on all date-ordered match-loss injuries sustained by AFL players during 1 full season were obtained. The total number of injuries per player was determined, and in those with >1 injury, the Subsequent Injury Classification (SIC) model was used to code all subsequent injuries based on their Orchard Sports Injury Classification System (OSICS) codes and the dates of injury. RESULTS: There were 860 newly recorded injuries in 543 players; 247 players (45.5%) sustained >/=1 subsequent injuries after an earlier injury, with 317 subsequent injuries (36.9% of all injuries) recorded overall. A subsequent injury generally occurred to a different body region and was therefore superficially unrelated to an index injury. However, 32.2% of all subsequent injuries were related to a previous injury in the same season. Hamstring injuries were the most common subsequent injury. The mean time between injuries decreased with an increasing number of subsequent injuries. CONCLUSION: When relationships between injuries are taken into account, there is a high level of subsequent (and multiple) injuries leading to missed games in an elite athlete group.