The epidemiology of head injuries at 2019 Rugby Union World Cup

ABSTRACT

Introduction

The sequelae of concussion are of growing concern within Rugby. World Rugby has introduced rule changes to improve player welfare and reduce head injury frequency. We aimed to report the incidence of head injuries and head injury assessment (HIA) at the 2019 Rugby World Cup (RWC).

Methods

We reviewed all 45 tournament matches and recorded the number of head injuries, the injured player’s position, and the mechanism of injury; whether the player had an HIA; and if they returned to play following injury. We compared these findings with previous RWCs.

Results

We recorded 68 head injuries (1.33/game). Thirty-six players (52.9%) were removed from the field of play for an HIA. Of these, 23 (63.9%) failed and therefore considered to have concussion. The head injury rate in 2019 was 37.8 per 1000 player hours, which increased from previous tournaments (22.0 in 2015, 14.6 in 2011, and 4.7 in 2007). The concussion rate was 23 per 1000 player hours in 2019, which was lower than 29 in 2015. In 2019, 63.9% of HIAs were failed compared to 48.7% in 2015. We identified 17 cases where medical staff did not attend to a player suffering a head injury on-field. Of these, four players underwent an HIA after the match doctor reviewed the incident.

Conclusion

We recorded a higher rate of head injuries, and a player was more likely to fail their HIA than in previous tournaments. These findings may represent a greater awareness from medical staff and the benefits of education. However, 25% of head injuries not receiving an initial on-field assessment provide room for improvement.

KEYWORDS:

• Head injury
• concussion
• Rugby
• professional athletes
• trauma

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics

Ethical approval was not sought for this study as we were performing an observational study of television footage, which was freely available to the general public, having been aired on ‘free to air’ national television in the United Kingdom. We did not have any access to any player data or medical reports, and our findings were purely based upon the television footage available.

Data are available upon reasonable request

Spreadsheet of completed proforma available on request from the corresponding author, containing the observed raw data. We have had no access to any player data or medical records and had only observations of ‘free to air’ television footage.

Patient and Public Involvement

No patient or public involvement as data were collected from reviewing television footage.

Additional information

Funding

The authors report no involvement in the research by the sponsor that could have influenced the outcome of this work.