Format

Send to

Choose Destination
J Pediatr. 2016 Jul;174:33-38.e2. doi: 10.1016/j.jpeds.2016.03.014. Epub 2016 Apr 4.

Specific Factors Influence Postconcussion Symptom Duration among Youth Referred to a Sports Concussion Clinic.

Author information

1
Division of Pediatric Neurology, Nationwide Children's Hospital, Columbus, OH; Department of Neurology, The Ohio State University, Columbus, OH. Electronic address: geoffrey.heyer@nationwidechildrens.org.
2
Department of Health Sciences, Clemson University, Clemson, SC.
3
Division of Pediatric Neurology, Nationwide Children's Hospital, Columbus, OH; Department of Neurology, The Ohio State University, Columbus, OH.
4
Division of Sports Medicine, Nationwide Children's Hospital, Columbus, OH.
5
Division of Pediatric Psychology and Neuropsychology, Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics, The Ohio State University, Columbus, OH.

Abstract

OBJECTIVE:

To identify the clinical factors that influence the duration of postconcussion symptoms among youth referred to a sports concussion clinic.

STUDY DESIGN:

A retrospective cohort study was conducted to evaluate several potential predictors of symptom duration via a Cox proportional hazards analyses. The individual postconcussion symptom scores were highly correlated, so these symptoms were analyzed in the statistical model as coefficients derived from principal component analyses.

RESULTS:

Among 1953 youth with concussion, 1755 (89.9%) had dates of reported symptom resolution. The remainder (10.1%) were lost to follow-up and censored. The median time to recovery was 18 days (range 1-353 days). By 30 days, 72.6% had recovered; by 60 days, 91.4% had recovered; and by 90 days, 96.8% had recovered. Several variables in a multivariate Cox model predicted postconcussion symptom duration: female sex (P < .001, hazard ratio [HR] = 1.28), continued activity participation (P = .02, HR = 1.13), loss of consciousness (P = .03, HR = 1.18), anterograde amnesia (P = .04, HR = 1.15), premorbid headaches (P = .03, HR = 1.15), symptom components from the day of concussion (emotion, P = .03, HR = 1.08), and the day of clinic evaluation (cognitive-fatigue, P < .001, HR = 1.22; cephalalgic, P < .001, HR = 1.27; emotional, P = .05, HR = 1.08; arousal-stimulation, P = .003, HR = 1.1). In univariate analyses, greater symptom scores generally predicted longer symptom durations. Worsening of symptoms from the day of concussion to the day of clinic evaluation also predicted longer recovery (P < .001, HR = 1.59).

CONCLUSIONS:

Several factors help to predict protracted postconcussion symptom durations among youth referred to a sports concussion clinic.

KEYWORDS:

TBI; adolescent; mTBI; pediatric; traumatic brain injury

PMID:
27056449
DOI:
10.1016/j.jpeds.2016.03.014
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center