Health-Related Quality of Life 5 to 15 Years Following Adolescent Sport-Related Injury: The SHRed Consequences of Injury Study

Objectives: This study examined the association between adolescent (aged 11–18 years) sport-related concussion (SRC) or musculoskeletal (MSK) injury and long-term (ie, 5–15 years postinjury) health-related quality of life (HRQoL). Design: This was a substudy of a historical cohort study. Setting: This study was conducted in a university setting. Participants: Individuals who participated in adolescent sport 5 to 15 years before assessment were included in this study. Assessment of Risk Factors Variables: Reports of SRC, MSK injury, or no injury during adolescent sport participation. Main Outcome Measures: Multivariable regression models assessed associations between an adolescent SRC or MSK injury and long-term HRQoL (EQ-5D-5L visual analog scale [VAS] and Index Score) standardized to Canadian population preferences. Models were adjusted for sex, time since injury, athlete identity, and 4 physical activity exposures modeled separately to reduce collinearity. Effect measure modification was evaluated for all two-way interactions. Results: A total of 325 individuals participated (aged 16–33 years). EQ-5D-5L median [interquartile range] scores were high across groups [Index Score, no injury: 0.91 (0.88, 0.95), MSK injury: 0.91 (0.87, 0.95), SRC: 0.91 (0.87, 0.95); VAS score, no injury: 85 (78, 90), MSK injury: 85 (78, 90), SRC: 85 (75, 90)]. The SRC group demonstrated lower EQ-5D-5L index scores across all models (β-range: −1.93 to −1.97, 95% confidence interval range: −3.61–0.34) compared with the uninjured group. No VAS score differences were observed between groups; however, the age-by-group interaction was significant, indicating lower VAS scores among older participants who sustained a SRC. Conclusion: Sport-related concussion may influence HRQoL years after injury, and targeted interventions focusing on the specific domains of HRQoL that are impacted may be indicated.