Immediate post catastrophic injury management in rugby union. Does it have an effect on outcomes?

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dc.contributor.advisorLambert, Michael Ien_ZA
dc.contributor.advisorBrown, James Craigen_ZA
dc.contributor.authorSuter, Jason Alexanderen_ZA
dc.date.accessioned2018-02-12T08:53:24Z
dc.date.available2018-02-12T08:53:24Z
dc.date.issued2017en_ZA
dc.description.abstractBackground: Rugby union ('rugby') has a high injury risk. These Injuries range from having minor consequences to catastrophic injuries with major life changing consequences. In South Africa, previous research indicated that the risk of catastrophic injury was high and that the immediate management was sub-optimal, worsening the injury outcome. In response, the South African Rugby Union launched the BokSmart nationwide injury prevention programme in 2008. Through education - mainly of coaches and referees - this programme aims to improve the prevention and management of catastrophic injuries. Moreover, the programme began administering a standardised questionnaire for all catastrophically injured players to assess the prevention and management of these injuries. Objectives: To assess whether factors in the immediate pre- and post-injury management of catastrophic injuries in rugby were associated with their outcome. In addition, as part of the BokSmart programme in Rugby in South Africa, there were modules developed as part of the education material delivered to referees and coaches in their workshops that deal specifically with safety in the playing environment, and the correct management of catastrophic injuries. We assessed whether these protocols within the modules were implemented. Design: A prospective, cohort study conducted on all catastrophic injuries in rugby collected through a standardised questionnaire by BokSmart between 2008 - 2014. Methods: Secondary analyses were performed on the information collected on all rugby-related catastrophic injuries in BokSmart's serious injury database. Injury outcomes were split into 'permanent' (permanently disabling and fatal) and 'non-permanent' (full recovery/ "near miss"). Immediate post injury management factors as well as protective equipment and ethnicity were analysed for their association with injury outcome using a Fisher's exact test. Results: There were 87 catastrophic injuries recorded between 2008 and 2014. Acute spinal cord injuries (ASCI) made up most of the catastrophic injuries (n=69) with traumatic brain injuries (TBI) the second most common (n = 11 injuries). There were 7 cardiac events. Black African players were associated with a 2.4 times higher proportion of permanent outcome that the injured White players (p=0.001). There was no association between any protective equipment or injury management (including optimal immobilization, time and method of transport taken to hospital) and ASCI outcome (non-permanent vs. permanent) Conclusions: Neither immediate post-injury management, nor the wearing of protective equipment was associated with catastrophic injury outcome in these South African rugby-related injuries. This might indicate that the initial injury is more important in determining the outcome than the post-injury management and associated secondary metabolic cascade, as proposed by some experts in this area. Moreover, that ethnicity was associated with ASCI outcome in this study is indicative of the wider problems in South Africa; not only specific to rugby. It is recommended that BokSmart continue to focus their programme in low socioeconomic areas that play rugby in South Africa.en_ZA
dc.identifier.apacitationSuter, J. A. (2017). <i>Immediate post catastrophic injury management in rugby union. Does it have an effect on outcomes?</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,MRC/UCT RU for Exercise and Sport Medicine. Retrieved from http://hdl.handle.net/11427/27519en_ZA
dc.identifier.chicagocitationSuter, Jason Alexander. <i>"Immediate post catastrophic injury management in rugby union. Does it have an effect on outcomes?."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,MRC/UCT RU for Exercise and Sport Medicine, 2017. http://hdl.handle.net/11427/27519en_ZA
dc.identifier.citationSuter, J. 2017. Immediate post catastrophic injury management in rugby union. Does it have an effect on outcomes?. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Suter, Jason Alexander AB - Background: Rugby union ('rugby') has a high injury risk. These Injuries range from having minor consequences to catastrophic injuries with major life changing consequences. In South Africa, previous research indicated that the risk of catastrophic injury was high and that the immediate management was sub-optimal, worsening the injury outcome. In response, the South African Rugby Union launched the BokSmart nationwide injury prevention programme in 2008. Through education - mainly of coaches and referees - this programme aims to improve the prevention and management of catastrophic injuries. Moreover, the programme began administering a standardised questionnaire for all catastrophically injured players to assess the prevention and management of these injuries. Objectives: To assess whether factors in the immediate pre- and post-injury management of catastrophic injuries in rugby were associated with their outcome. In addition, as part of the BokSmart programme in Rugby in South Africa, there were modules developed as part of the education material delivered to referees and coaches in their workshops that deal specifically with safety in the playing environment, and the correct management of catastrophic injuries. We assessed whether these protocols within the modules were implemented. Design: A prospective, cohort study conducted on all catastrophic injuries in rugby collected through a standardised questionnaire by BokSmart between 2008 - 2014. Methods: Secondary analyses were performed on the information collected on all rugby-related catastrophic injuries in BokSmart's serious injury database. Injury outcomes were split into 'permanent' (permanently disabling and fatal) and 'non-permanent' (full recovery/ "near miss"). Immediate post injury management factors as well as protective equipment and ethnicity were analysed for their association with injury outcome using a Fisher's exact test. Results: There were 87 catastrophic injuries recorded between 2008 and 2014. Acute spinal cord injuries (ASCI) made up most of the catastrophic injuries (n=69) with traumatic brain injuries (TBI) the second most common (n = 11 injuries). There were 7 cardiac events. Black African players were associated with a 2.4 times higher proportion of permanent outcome that the injured White players (p=0.001). There was no association between any protective equipment or injury management (including optimal immobilization, time and method of transport taken to hospital) and ASCI outcome (non-permanent vs. permanent) Conclusions: Neither immediate post-injury management, nor the wearing of protective equipment was associated with catastrophic injury outcome in these South African rugby-related injuries. This might indicate that the initial injury is more important in determining the outcome than the post-injury management and associated secondary metabolic cascade, as proposed by some experts in this area. Moreover, that ethnicity was associated with ASCI outcome in this study is indicative of the wider problems in South Africa; not only specific to rugby. It is recommended that BokSmart continue to focus their programme in low socioeconomic areas that play rugby in South Africa. DA - 2017 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - Immediate post catastrophic injury management in rugby union. Does it have an effect on outcomes? TI - Immediate post catastrophic injury management in rugby union. Does it have an effect on outcomes? UR - http://hdl.handle.net/11427/27519 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/27519
dc.identifier.vancouvercitationSuter JA. Immediate post catastrophic injury management in rugby union. Does it have an effect on outcomes?. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,MRC/UCT RU for Exercise and Sport Medicine, 2017 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/27519en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentMRC/UCT RU for Exercise and Sport Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherSports Medicineen_ZA
dc.titleImmediate post catastrophic injury management in rugby union. Does it have an effect on outcomes?en_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPhilen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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