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Concussion and its diagnosis, prevention, and treatment remain a challenge for National Football League (NFL) players The NFL has focused on concussions as of late The elite NFL athlete is unique 40% of retired NFL players have signs of CTE based on sensitive MRI scans Knowing the short-term effects of concussion are just as important as the long-term effects INTRODUCTION Establish the short-term outcomes among concussed NFL players in terms of: (1)Franchise release rate (2)Career length (3)Mean salary (4)Performance OBJECTIVES METHODS Of the total 5,587 NFL players over the 11-year period from 2005-2016, 307 players noted as sustaining publicly reported concussions resulting in DNP injury protocol. Annual release rate of the post-concussive versus non-concussive players: 33.6% vs. 21.6%, (p<0.001) Mean year-over-year change in contract value for concussed players after DNP protocol activation Reduction of $300,000/year ± $1,300,000/year. Likelihood of a concussed player remaining in the NFL after 3yrs: 30.1% vs 54.2% (p<0.001) Likelihood of a concussed player remaining in the NFL after 5yrs was 11.6% vs 36.6% (p<0.001) Fantasy scoring: pre-concussion average of 7.1± 14.2 FFP/game vs post- concussion 6.4 ± 10.4 FFP/game (p=0.047). RESULTS CONCLUSION Our retrospective study is the largest evaluating NFL concussions Concussed NFL players were released by non-concussed players within the year of sustaining a concussion at a higher rate Concussed players had a 70% chance of not remaining in the league 3 years later Concussed players had a 88% chance of not remaining in the league at 5 years Released players suffered reduction in year-over-year accumulated earnings of $300,000 per year the player remained in the league Concussed players performed worse on the field prior to their injury Performance decreases were greatest for tight ends, running backs, wide receivers, and quarterbacks after concussion. DATA REFERENCES 1. Profootballreference.com 2. Nfl.com 3. Spotrac.com 4. Fantasydata.com 5. Prosportstransactions.com Prem N. Ramkumar MD MBA 1 , Sergio M. Navarro BS 2 1 Cleveland Clinic, Dept of Orthopaedic Surgery , 2 Baylor College of Medicine, Dept of Orthopaedic Surgery Short-Term Outcomes Following Concussion in the NFL: An 11-year Case-Control Study of Player Release Rate and Financial Loss -2.5 -2.0 -1.5 -1.0 -0.5 0.0 0.5 1.0 1.5 0-1yrs 1-2yrs 2-3yrs 3-4yrs 4-5yrs 5-7yrs 7-10yrs 10yrs+ Salary Change ($mm/yr) Career Length Survival curves comparing career length of concussive vs. non-concussive players Post-concussion salary change based on career length Release rate data for all players studied over 11-year period 2002 Dr. Omalu autopsy of Mike Webster 2005 Pellman et al report 50% of concussed players had same-game RTP 2009 NFL insEtutes policy stopping same-game RTP 2011 NFL insEtutes sideline concussion assessment protocol 2013 NFL adds to concussion protocol and recruits sideline neurologists and establishes baseline tesEng with preseason educaEon 2016 NFL insEtutes financial penalty on franchises noncompliant with concussion protocols 2017 Rule changes to the game to increase player safety RetrospecEve Study Design of NFL Players (2005-2016) Case-control: Concussed vs. Non- concussed Franchise Release Rate Career length ObservaEonal: Pre-concussion vs Post-Concussion Salary Performance

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Page 1: Short-Term Outcomes Following Concussion in the NFL: An 11 ... · • Likelihood of a concussed player remaining in the NFL after 5yrs was 11.6% vs 36.6% (p

•  Concussion and its diagnosis, prevention, and treatment remain a challenge for National Football League (NFL) players

•  The NFL has focused on concussions as of late

The elite NFL athlete is unique •  40% of retired NFL players have

signs of CTE based on sensitive MRI scans

•  Knowing the short-term effects of concussion are just as important as the long-term effects

INTRODUCTION

•  Establish the short-term outcomes among concussed NFL players in terms of:

(1) Franchise release rate (2) Career length (3) Mean salary (4) Performance

OBJECTIVES

METHODS

•  Of the total 5,587 NFL players over the 11-year period from 2005-2016, 307 players noted as sustaining publicly reported concussions resulting in DNP injury protocol.

•  Annual release rate of the post-concussive versus non-concussive players: 33.6% vs. 21.6%, (p<0.001)

•  Mean year-over-year change in contract value for concussed players after DNP protocol activation Reduction of $300,000/year ± $1,300,000/year.

•  Likelihood of a concussed player remaining in the NFL after 3yrs: 30.1% vs 54.2% (p<0.001)

•  Likelihood of a concussed player remaining in the NFL after 5yrs was 11.6% vs 36.6% (p<0.001)

•  Fantasy scoring: pre-concussion average of 7.1± 14.2 FFP/game vs post-concussion 6.4 ± 10.4 FFP/game (p=0.047).

RESULTS

CONCLUSION •  Our retrospective study is the largest

evaluating NFL concussions •  Concussed NFL players were

released by non-concussed players within the year of sustaining a concussion at a higher rate

•  Concussed players had a 70% chance of not remaining in the league 3 years later

•  Concussed players had a 88% chance of not remaining in the league at 5 years

•  Released players suffered reduction in year-over-year accumulated earnings of $300,000 per year the player remained in the league

•  Concussed players performed worse on the field prior to their injury

•  Performance decreases were greatest for tight ends, running backs, wide receivers, and quarterbacks after concussion.

DATA REFERENCES 1.  Profootballreference.com 2.  Nfl.com 3.  Spotrac.com 4.  Fantasydata.com 5.  Prosportstransactions.com

Prem N. Ramkumar MD MBA1 , Sergio M. Navarro BS2 1Cleveland Clinic, Dept of Orthopaedic Surgery , 2Baylor College of Medicine, Dept of Orthopaedic Surgery

Short-Term Outcomes Following Concussion in the NFL: An 11-year Case-Control Study of Player Release Rate and Financial Loss

-2.5 -2.0 -1.5 -1.0 -0.5 0.0 0.5 1.0 1.5

0-1yrs

1-2yrs

2-3yrs

3-4yrs

4-5yrs

5-7yrs

7-10yrs

10yrs+

Salary Change ($mm/yr)

Car

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Survival curves comparing career length of concussive vs. non-concussive players Post-concussion salary change

based on career length

Release rate data for all players studied over

11-year period

2002Dr.Omaluautopsyof

MikeWebster

2005Pellmanetalreport50%ofconcussedplayershadsame-game

RTP 2009NFLinsEtutes

policystopping

same-gameRTP

2011NFLinsEtutes

sidelineconcussionassessmentprotocol

2013NFLaddstoconcussionprotocoland

recruitssideline

neurologistsand

establishesbaseline

tesEngwithpreseasoneducaEon

2016NFLinsEtutes

financialpenaltyonfranchises

noncompliantwith

concussionprotocols

2017Rulechangestothegametoincreaseplayersafety

RetrospecEveStudyDesignofNFLPlayers(2005-2016)

Case-control:Concussedvs.Non-

concussed

FranchiseReleaseRate Careerlength

ObservaEonal:Pre-concussionvsPost-Concussion

Salary Performance