781 BO03 – Do some rugby league players and teams disproportionately cause and receive head injury assessments (HIA)?

Background The Head Injury Assessment (HIA) improve the identification of suspected concussions at elite levels, although whether certain teams, playing positions or player disproportionately cause or receive HIA in rugby league is unknown. Objective Describe and compare differences in incidence rates for players to cause or receive head injury assessments (HIAs), by playing position, team, and tackler event roles (i.e., ball carrier vs. tackler) in professional male rugby league. Design Retrospective cohort study Setting Super League rugby league. Participants 481 players from 13 teams in 305 matches during 2021 and 2022 Super League seasons. Assessment of Risk Factors Generalised linear mixed-effects models were used to compare incidence rate ratios between player event roles (i.e., ball carrier vs. tackler), playing positions, teams, and individual players. Main Outcome Measurements Head Injury Assessment (HIA) incidence rates and Incidence Rate Ratios. Results Tacklers had significantly greater incidence (1.56 HIAs per 1,000 tackles [95% confidence interval [CI] = 1.49–1.63]) than ball carriers (1.04 [0.97–1.11]). Compared to the median position, fullbacks (1.96 [1.09–3.52]), wingers (1.47 [0.85–2.54]), and centres (1.34 [0.86–2.10]) had the highest incidence of receiving HIAs. Wingers (1.64 [0.95–2.86]), fullbacks (1.14 [0.55–2.33]), and props (0.96 [95% CI = 0.68–1.35]) had the highest incidence of causing HIAs when compared to the median position. In comparison to the median team and player, three teams and five individual players had exhibited a significantly greater incidence of receiving HIAs. Additionally, three different teams and six different individual players had a significantly greater incidence of causing HIAs. Conclusions Given some playing positions, teams, and individual players have a greater incidence of causing or receiving HIA, targeted prevention strategy are required to reduce HIAs. This would focus on fullbacks, wingers, centres, props, and individual teams (3/13 causing and 3/13 receiving), and players (5/481 causing and 6/481 receiving).