scholarly journals Mortality risk factors among National Football League players: An analysis using player career data

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 2022
Author(s):  
Justin Ehrlich ◽  
Brittany Kmush ◽  
Bhavneet Walia ◽  
Shane Sanders
Keyword(s):  
Head Trauma ◽  
Mortality Risk ◽  
National Football League ◽  
P Value ◽  
Age At Death ◽  
Healthy Worker Effect ◽  
Explanatory Variables ◽  
Fit Statistics ◽  
Using Data

In general, National Football League (NFL) players tend to live longer than the general population. However, little information exists about the long-term mortality risk in this population. Frequent, yet mild, head trauma may be associated with early mortality in this group of elite athletes. Therefore, career playing statistics can be used as a proxy for frequent head trauma. Using data from Pro Football Reference, we analyzed the association between age-at-death, position, and NFL seasons-played among 6,408 NFL players that were deceased as of July 1, 2018. The linear regression model allowing for a healthy worker effect demonstrated the best fit statistics (F-statistic = 9.95, p-value = 0.0016). The overall association of age-at-death and seasons-played is positive beginning at the 10.75 and 10.64 seasons-played point in our two models that feature seasons-played and seasons-played squared as explanatory variables. Previous research that does not account for this survivorship bias/healthy worker effect may not adequately describe mortality risk among NFL players.

scholarly journals Mortality risk factors among National Football League players: An analysis using player career data

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 2022
Author(s):  
Justin Ehrlich ◽  
Brittany Kmush ◽  
Bhavneet Walia ◽  
Shane Sanders
Keyword(s):  
Head Trauma ◽  
Mortality Risk ◽  
National Football League ◽  
P Value ◽  
Age At Death ◽  
Healthy Worker Effect ◽  
Explanatory Variables ◽  
Fit Statistics ◽  
Using Data

In general, National Football League (NFL) players tend to live longer than the general population. However, little information exists about the long-term mortality risk in this population. Frequent, yet mild, head trauma may be associated with early mortality in this group of elite athletes. Therefore, career playing statistics can be used as a proxy for frequent head trauma. Using data from Pro Football Reference, we analyzed the association between age-at-death, position, and NFL seasons-played among 6,408 NFL players that were deceased as of July 1, 2018. The linear regression model allowing for a healthy worker effect demonstrated the best fit statistics (F-statistic = 9.95, p-value = 0.0016). The overall association of age-at-death and seasons-played is positive beginning at the 10.75 and 10.64 seasons-played point in our two models that feature seasons-played and seasons-played squared as explanatory variables. Previous research that does not account for the healthy worker effect may not adequately describe mortality risk among NFL players.

scholarly journals Mortality risk factors among National Football League players: An analysis using player career data

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 2022
Author(s):  
Justin Ehrlich ◽  
Brittany Kmush ◽  
Bhavneet Walia ◽  
Shane Sanders
Keyword(s):  
Head Trauma ◽  
Mortality Risk ◽  
National Football League ◽  
P Value ◽  
Age At Death ◽  
Healthy Worker Effect ◽  
Explanatory Variables ◽  
Fit Statistics ◽  
Using Data

In general, National Football League (NFL) players tend to live longer than the general population. However, little information exists about the long-term mortality risk in this population. Frequent, yet mild, head trauma may be associated with early mortality in this group of elite athletes. Therefore, career playing statistics can be used as a proxy for frequent head trauma. Using data from Pro Football Reference, we analyzed the association between age-at-death, position, and NFL seasons-played among 6,408 NFL players that were deceased as of July 1, 2018. The linear regression model allowing for a healthy worker effect demonstrated the best fit statistics (F-statistic = 9.95, p-value = 0.0016). The overall association of age-at-death and seasons-played is positive beginning at the 10.75 and 10.64 seasons-played point in our two models that feature seasons-played and seasons-played squared as explanatory variables. Previous research that does not account for this survivorship bias/healthy worker effect may not adequately describe mortality risk among NFL players.

scholarly journals Age at League Entry and Early All-Cause Mortality among National Football League Players

2021 ◽  
Vol 18 (24) ◽  
pp. 13356
Author(s):  
Bhavneet Walia ◽  
Brittany L. Kmush ◽  
Justin Ehrlich ◽  
Madeline Mackowski ◽  
Shane Sanders
Keyword(s):  
Emerging Adults ◽  
Mortality Risk ◽  
National Football League ◽  
Cox Regression ◽  
Disease Onset ◽  
Early Mortality ◽  
American Football ◽  
Increased Risk ◽  
All Cause Mortality

Background: A growing body of research suggests that American football players are exposed to higher cumulative head impact risk as competition level rises. Related literature finds that head impacts absorbed by youth, adolescent, and emerging adult players are associated with elevated risk of long-term health problems (e.g., neurodegenerative disease onset). Most National Football League (NFL) players enter the League as emerging adults (18–24 years old), a period of continued cognitive and overall physical development. However, no prior research has studied the effect of age-at-entry on long-term NFL player health. Hypothesis/Purpose: This study assesses whether early NFL player age-at-entry is associated with increased risk of early all-cause mortality, controlling for player position, BMI, year-of-entry, birth year, and NFL Draft round (expected ability upon League entry). Study Design: This retrospective cohort study included 9049 players who entered the NFL from 1970–2017 and subsequently played at least one game. The variables whether deceased, age-at-death, age-at-entry, and controls were collected from Pro Football Reference website, a leading data site for American football that has been used extensively in the literature. Data collection began on 13 July 2017, and follow-up ended on 1 July 2018. Statistical analysis was performed from 10 March 2020 to 3 August 2020. Data was validated by checking a large sub-sample of data points against alternative sources such as NFL.com and NFLsavant.com. Methods: Cox proportional hazards regression models were used to examine variation in death hazard by NFL player age-at-entry, conditional upon a full set of controls. Results: Conditional on controls, Cox regression results indicate that a one-year increase in age-at-entry was significantly associated with a 14% decreased hazard-of-death (H.R., 0.86; 95% CI, 0.74–0.98). Among relatively young entering players, the increased hazard appears to be concentrated in the first quartile of players by age at League entry (20.2 to 22.3 years). Players not in this quartile exhibited a decreased hazard-of-death (H.R., 0.74; 95% CI, 0.57–0.97) compared with players who entered at a relatively young (first quartile) age. Conclusion: An earlier age-at-entry is associated with an increased hazard-of-death among NFL players. Currently, the NFL regulates age-at-entry only indirectly by requiring players to be 3 years removed from high school before becoming NFL Draft-eligible. Implementing a minimum age at entry for NFL players of 22 years and 4 months at beginning of season is expected to result in reduced mortality. What is known about this subject? There are no prior studies on the effects of NFL player age-at-entry on early mortality risk. What this study adds to existing knowledge: This study determines whether entering the NFL at an age of physical and physiological development is related to early mortality risk.

Testosterone Deficiency, Long-Term Testosterone Therapy, and Inflammation

2021 ◽  
pp. 107424842110324
Author(s):  
Xiao Zhang ◽  
Hongwei Zhao ◽  
Jennifer Horney ◽  
Natalie Johnson ◽  
Farid Saad ◽  
...  
Keyword(s):  
High Sensitivity ◽  
Cross Sectional Study ◽  
Control Group ◽  
P Value ◽  
Testosterone Deficiency ◽  
Testosterone Therapy ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Using Data

Objectives: We aimed to evaluate the association of testosterone deficiency with inflammation and how long-term testosterone therapy affects inflammation biomarkers over time. Methods: We conducted a 2-component study. First, we conducted a cross-sectional study using the recently released 2015-2016 National Health and Nutrition Examination Survey (NHANES) data to examine the association between testosterone deficiency and inflammation biomarkers including high sensitivity C-reactive protein (hsCRP), liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the US general population. Then we conducted a longitudinal study to investigate the longitudinal effect of testosterone therapy on inflammation biomarkers and the risk of cardiovascular events, using data from 776 hypogonadal men based on a registry study in Germany with up to 11 years’ follow-up. Results: The adjusted odds ratios (ORs) describing the associations between testosterone deficiency and hsCRP ≥ 3mg/L, ALT > 40U/L, and AST > 40U/L were 1.81 ( P-value < 0.001), 1.46 ( P-value = 0.009), and 0.99 ( P-value = 0.971), respectively. In the control group, CRP, ALT, and AST levels increased by 0.003 (95%CI: −0.001, 0.007) mg/L, 0.157 U/L (95%CI: 0.145, 0.170), and 0.147 (95%CI: 0.136, 0.159) U/L per month, while in the treatment group, CRP, ALT, and AST levels decreased by 0.05 (95%CI: −0.055, −0.046) mg/L, 0.142 U/L (95%CI: −0.154, −0.130), and 0.148 (95%CI: −0.158, −0.137) U/L per month. Conclusion: Testosterone deficiency was associated with an increased level of inflammation; long-term testosterone therapy alleviated inflammation among hypogonadal men, which may contribute to the reduced cardiovascular risk. Future large trials are warranted to confirm our observational study findings.

Abusive head trauma (AHT) outcome at long-term follow-up and the role of elective neurosurgical approach: A report of 22 cases

2013 ◽  
Author(s):  
Francesca Menegazzo ◽  
Melissa Rosa Rizzotto ◽  
Martina Bua ◽  
Luisa Pinello ◽  
Elisabetta Tono ◽  
...  
Keyword(s):  
Head Trauma ◽  
Abusive Head Trauma ◽  
Long Term Follow Up

A Strategy for Analysing Multiple Risk Factors with Application to Cervical Pain Syndrome

1989 ◽  
Vol 28 (01) ◽  
pp. 14-19 ◽  
Author(s):  
J. F. Dartigues ◽  
Ph. Peytour ◽  
E. Puymirat ◽  
P. Henry ◽  
M. Gagnon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Low Power ◽  
Head Trauma ◽  
Pain Syndrome ◽  
Psychological Status ◽  
Confounding Factors ◽  
Cervical Pain ◽  
Extreme Form ◽  
Explanatory Variables ◽  
Multiple Risk Factors

Abstract:When studying the possible effects of several factors in a given disease, two major problems arise: (1) confounding, and (2) multiplicity of tests. Frequently, in order to cope with the problem of confounding factors, models with multiple explanatory variables are used. However, the correlation structure of the variables may be such that the corresponding tests have low power: in its extreme form this situation is coined by the term “multicollinearity”. As the problem of multiplicity is still relevant in these models, the interpretation of results is, in most cases, very hazardous. We propose a strategy - based on a tree structure of the variables - which provides a guide to the interpretation and controls the risk of erroneously rejecting null hypotheses. The strategy was applied to a study of cervical pain syndrome involving 990 subjects and 17 variables. Age, sex, head trauma, posture at work and psychological status were all found to be important risk factors.

Isolated Liner Revision for Total Knee Arthroplasty Instability: A Road That Should Remain Less Taken

2020 ◽  
Author(s):  
Jason D. Tegethoff ◽  
Rafael Walker-Santiago ◽  
William M. Ralston ◽  
James A. Keeney
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
P Value ◽  
Surgical Morbidity ◽  
Exact Test ◽  
Total Knee ◽  
Component Revision

AbstractIsolated polyethylene liner exchange (IPLE) is infrequently selected as a treatment approach for patients with primary total knee arthroplasty (TKA) prosthetic joint instability. Potential advantages of less immediate surgical morbidity, faster recovery, and lower procedural cost need to be measured against reoperation and re-revision risk. Few published studies have directly compared IPLE with combined tibial and femoral component revision to treat patients with primary TKA instability. After obtaining institutional review board (IRB) approval, we performed a retrospective comparison of 20 patients treated with IPLE and 126 patients treated with tibial and femoral component revisions at a single institution between 2011 and 2018. Patient demographic characteristics, medical comorbidities, time to initial revision TKA, and reoperation (90 days, <2 years, and >2 years) were assessed using paired Student's t-test or Fisher's exact test with a p-value <0.01 used to determine significance. Patients undergoing IPLE were more likely to undergo reoperation (60.0 vs. 17.5%, p = 0.001), component revision surgery (45.0 vs. 8.7%, p = 0.002), and component revision within 2 years (30.0 vs. 1.6%, p < 0.0001). Differences in 90-day reoperation (p = 0.14) and revision >2 years (p = 0.19) were not significant. Reoperation for instability (30.0 vs. 4.0%, p < 0.001) and infection (20.0 vs. 1.6%, p < 0.01) were both higher in the IPLE group. IPLE does not provide consistent benefits for patients undergoing TKA revision for instability. Considerations for lower immediate postoperative morbidity and cost need to be carefully measured against long-term consequences of reoperation, delayed component revision, and increased long-term costs of multiple surgical procedures. This is a level III, case–control study.

Concussion, neuroethics, and sport: Policies of the past do not suffice for the future

2017 ◽  
Author(s):  
Brad Partridge ◽  
Wayne Hall
Keyword(s):  
Mental Health ◽  
Head Trauma ◽  
Mental Health Problems ◽  
Ethical Issues ◽  
Cognitive Impairments ◽  
Concussion Management ◽  
Design And Implementation ◽  
The Past ◽  
Management Policies

Concussion management policies have become a major priority worldwide for sports that involve frequent collisions between participants because repeated head trauma has been associated with long-term cognitive impairments, mental health problems, and some forms of neurological degeneration. A number of concussion management policies have been developed by professional bodies and subsequently adopted by various sporting leagues. These have offered little guidance on how to navigate ethical issues in identifying and managing concussion. This chapter discusses ethical issues that arise in the diagnosis of concussion, debates about the longer-term consequences of repeated concussion injuries, and the design and implementation of policies that aim to prevent and manage concussion injuries in sporting matches.

Clinical impact of myositis-specific autoantibodies on long-term prognosis of juvenile idiopathic inflammatory myopathies: multicentre study

Rheumatology ◽  
2021 ◽  
Author(s):  
Yuichi Yamasaki ◽  
Norimoto Kobayashi ◽  
Shinji Akioka ◽  
Kazuko Yamazaki ◽  
Shunichiro Takezaki ◽  
...  
Keyword(s):  
Matrix Protein ◽  
Multiple Drug ◽  
Idiopathic Inflammatory Myopathies ◽  
Inflammatory Myopathies ◽  
Gamma Subunits ◽  
Specific Autoantibody ◽  
Long Term Prognosis ◽  
Using Data ◽  
Drug Free

Abstract Objectives This study aimed to investigate the clinical characteristics, treatment and prognosis of juvenile idiopathic inflammatory myopathies (JIIM) in Japan for each myositis-specific autoantibody (MSA) profile. Methods A multicentre, retrospective study was conducted using data of patients with JIIM at nine paediatric rheumatology centres in Japan. Patients with MSA profiles, determined by immunoprecipitation using stored serum from the active stage, were included. Results MSA were detected in 85 of 96 cases eligible for the analyses. Over 90% of the patients in this study had one of the following three MSA types: anti-melanoma differentiation-associated protein 5 (MDA5) (n = 31), anti-transcriptional intermediary factor 1 alpha and/or gamma subunits (TIF1γ) (n = 25) and anti-nuclear matrix protein 2 (NXP2) (n = 25) antibodies. Gottron papules and periungual capillary abnormalities were the most common signs of every MSA group in the initial phase. The presence of interstitial lung disease (ILD) was the highest risk factor for patients with anti-MDA5 antibodies. Most patients were administered multiple drug therapies: glucocorticoids and MTX were administered to patients with anti-TIF1γ or anti-NXP2 antibodies. Half of the patients with anti-MDA5 antibodies received more than three medications including i.v. CYC, especially patients with ILD. Patients with anti-MDA5 antibodies were more likely to achieve drug-free remission (29 vs 21%) and less likely to relapse (26 vs 44%) than others. Conclusion Anti-MDA5 antibodies are the most common MSA type in Japan, and patients with this antibody are characterized by ILD at onset, multiple medications including i.v. CYC, drug-free remission, and a lower frequency of relapse. New therapeutic strategies are required for other MSA types.

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