Specific Factors Influence Postconcussion Symptom Duration
among Youth Referred to a Sports Concussion Clinic
among Youth Referred to a Sports Concussion Clinic
Heyer
GL., Schaffer CE., Rose SC., Young JA., McNally KA., Fischer AN. J Pediatr.
2016: ahead of print
GL., Schaffer CE., Rose SC., Young JA., McNally KA., Fischer AN. J Pediatr.
2016: ahead of print
Take Home Message:
Clinical factors that related with persistent postconcussion symptoms were sex,
greater worsening symptoms from day of concussion to first concussion
evaluation, continued activity participation, loss of consciousness,
anterograde amnesia, and premorbid headaches, emotional symptoms on the day of
concussion, and greater symptoms the day of the clinical examination.
Clinical factors that related with persistent postconcussion symptoms were sex,
greater worsening symptoms from day of concussion to first concussion
evaluation, continued activity participation, loss of consciousness,
anterograde amnesia, and premorbid headaches, emotional symptoms on the day of
concussion, and greater symptoms the day of the clinical examination.
Recovery
following a concussion is still largely understood. Previous researchers
suggest clinical factors (for example, concussion history, specific symptoms,
sex) are associated with protracted recovery; however, due to inconsistencies
and the variety of research designs it is difficult to determine if these
patterns truly exist. Therefore, the authors reviewed medical records to
identify clinical factors that influence the duration of postconcussion
symptoms among youth referred to a sports concussion clinic between June 2012
and September 2014. The authors analyzed 1,953 electronic medical records.
These patients were included based on 2 primary criteria: they were between 10
to 19 years of age and the initial concussion evaluation was performed within
30 days of injury. Among the 1,953 patients, 1,755 (89%) had symptom resolution
dates. The median time for symptom resolution was 18 days. By 30 days, 72% of
the patients recovered and by 60 days 91% of the patients recovered. One of the
largest risk factors for persistent postconcussion symptoms was sex. A female
was 28% more likely to have protracted concussion symptoms than a male patient.
Other clinical factors that related with persistent postconcussion symptoms
were greater worsening symptoms from day of concussion to first concussion
evaluation, continued activity participation, loss of consciousness,
anterograde amnesia, and premorbid headaches, emotional symptoms on the day of
concussion, and greater symptoms the day of the clinical examination (excluding
vomiting or somatic symptoms).
following a concussion is still largely understood. Previous researchers
suggest clinical factors (for example, concussion history, specific symptoms,
sex) are associated with protracted recovery; however, due to inconsistencies
and the variety of research designs it is difficult to determine if these
patterns truly exist. Therefore, the authors reviewed medical records to
identify clinical factors that influence the duration of postconcussion
symptoms among youth referred to a sports concussion clinic between June 2012
and September 2014. The authors analyzed 1,953 electronic medical records.
These patients were included based on 2 primary criteria: they were between 10
to 19 years of age and the initial concussion evaluation was performed within
30 days of injury. Among the 1,953 patients, 1,755 (89%) had symptom resolution
dates. The median time for symptom resolution was 18 days. By 30 days, 72% of
the patients recovered and by 60 days 91% of the patients recovered. One of the
largest risk factors for persistent postconcussion symptoms was sex. A female
was 28% more likely to have protracted concussion symptoms than a male patient.
Other clinical factors that related with persistent postconcussion symptoms
were greater worsening symptoms from day of concussion to first concussion
evaluation, continued activity participation, loss of consciousness,
anterograde amnesia, and premorbid headaches, emotional symptoms on the day of
concussion, and greater symptoms the day of the clinical examination (excluding
vomiting or somatic symptoms).
The
authors assessed medical records from a large cohort of youth patients with concussions,
and found several clinical factors that were related with protracted concussion
symptom duration. The authors found several clinical factors that are similar
to previous reports. One of the most consistent factors for protracted
concussion symptom duration is postconcussion signs and symptoms. The authors
of the current study also found that emotional symptoms
(sadness, feeling more emotional, irritability, nervous) at the time of injury were
related with prolonged recovery. Returning to activity was also a clinical risk
factor for prolonged symptom duration. It is important to point out that this
is the only clinical factor that could potentially be prevented. Therefore,
this suggests that protracted concussion symptoms could be alleviated with
proper education about what youth athletes should do following a potential
concussion event. Lastly, one of the largest risk factors was female sex.
Although other studies have found female sex to be a predictor of protracted
symptoms there is little explanation that suggests why. We also need to
acknowledge that this study found clinical factors that may make someone more
likely to have a protracted recovery. However, it is unclear how accurate these
factors would be at predicting who would have a protracted recovery. Medical
professionals should be aware of these clinical factors, which relate with a protracted
symptom duration, and discuss the potential for a slower recovery process with
patients that have one or more of these clinical factors.
authors assessed medical records from a large cohort of youth patients with concussions,
and found several clinical factors that were related with protracted concussion
symptom duration. The authors found several clinical factors that are similar
to previous reports. One of the most consistent factors for protracted
concussion symptom duration is postconcussion signs and symptoms. The authors
of the current study also found that emotional symptoms
(sadness, feeling more emotional, irritability, nervous) at the time of injury were
related with prolonged recovery. Returning to activity was also a clinical risk
factor for prolonged symptom duration. It is important to point out that this
is the only clinical factor that could potentially be prevented. Therefore,
this suggests that protracted concussion symptoms could be alleviated with
proper education about what youth athletes should do following a potential
concussion event. Lastly, one of the largest risk factors was female sex.
Although other studies have found female sex to be a predictor of protracted
symptoms there is little explanation that suggests why. We also need to
acknowledge that this study found clinical factors that may make someone more
likely to have a protracted recovery. However, it is unclear how accurate these
factors would be at predicting who would have a protracted recovery. Medical
professionals should be aware of these clinical factors, which relate with a protracted
symptom duration, and discuss the potential for a slower recovery process with
patients that have one or more of these clinical factors.
Questions for Discussion:
Would knowing these clinical factors change or alter your concussion assessment
and return to play protocol? Do these clinical factors align with what you see
in your concussion population with prolonged symptom recovery?
Would knowing these clinical factors change or alter your concussion assessment
and return to play protocol? Do these clinical factors align with what you see
in your concussion population with prolonged symptom recovery?
Written
by: Jane McDevitt, PhD
by: Jane McDevitt, PhD
Reviewed
by: Jeff Driban
by: Jeff Driban
Related
Posts:
Posts:
Heyer GL, Schaffer CE, Rose SC, Young JA, McNally KA, & Fischer AN (2016). Specific Factors Influence Postconcussion Symptom Duration among Youth Referred to a Sports Concussion Clinic. The Journal of pediatrics PMID: 27056449