Risk factors for concussive symptoms 1 week or longer
in high school athletes
in high school athletes
Chrisman
SP, Rivara FP, Schiff MA, Zhou C, Comstock RD. Brain Injury. 2013; 27(1): 1-9.
SP, Rivara FP, Schiff MA, Zhou C, Comstock RD. Brain Injury. 2013; 27(1): 1-9.
Most
athletes’ concussive symptoms are alleviated within 1 week; however, some
athletes’ concussive symptoms may last longer. If we could identify risk factors
for concussive symptoms that persists for over 1 week then this could lead to
better evidence-based return-to-play policies since we could apply more
cautious restrictions on patients with those risk factors. The purpose of this
study was to determine the risk factors for concussive symptoms that persist
for over 1 week among high school athletes. Additionally, the authors wanted to
determine whether risk factors were different for football compared to other
sports. Researchers analyzed data from the National High School Sports-Related
Injury Surveillance System Reporting Information Online from fall of 2006 to
spring of 2009. This data included 1412 concussions from a nationally
representative set of data from 100 different high schools. Athletic trainers
were asked to report on concussion symptom duration categorically: <15
minutes, 15 to 29 minutes, 30 to 59 minutes, 1 to 11 hours, 12 to 23 hours, 1
to 3 days, 4 to 6 days, 1 week to 1 month, or >1 month. Health logs were
obtained from a randomly selected 5% sample of reporting high schools to verify
what they report on the surveillance system, and each year the data was
considered very accurate. Most of the concussions occurred in football (58%).
The next most common contributors were girls’ soccer (10%) and girls’
basketball (7%). Most athletes with concussions reported 4 or more symptoms at
the time of injury (61%). Some athletes reported 3 symptoms (20%), but very few
reported 2 (14%) or just 1 (5%) symptoms at the time of injury. Athletes presenting
with 4 or more symptoms were 2 times more likely to have concussion symptoms ≥ 1
week in both football and non-football sports. Furthermore, athletes that
reported feeling drowsy, nausea, or confusion with concentration difficulties at
the time of the injury were more likely to have concussion symptoms ≥ 1 week in
all sports. Concentration difficulties (without confusion) were associated with
a 2.3-fold greater risk for concussion symptoms lasting ≥ 1 week in football
players. Finally, sensitivity to both light and noise was associated with a
2.7-fold increase of risk for concussive symptoms lasting ≥ 1 week in
non-football players but not in football players.
athletes’ concussive symptoms are alleviated within 1 week; however, some
athletes’ concussive symptoms may last longer. If we could identify risk factors
for concussive symptoms that persists for over 1 week then this could lead to
better evidence-based return-to-play policies since we could apply more
cautious restrictions on patients with those risk factors. The purpose of this
study was to determine the risk factors for concussive symptoms that persist
for over 1 week among high school athletes. Additionally, the authors wanted to
determine whether risk factors were different for football compared to other
sports. Researchers analyzed data from the National High School Sports-Related
Injury Surveillance System Reporting Information Online from fall of 2006 to
spring of 2009. This data included 1412 concussions from a nationally
representative set of data from 100 different high schools. Athletic trainers
were asked to report on concussion symptom duration categorically: <15
minutes, 15 to 29 minutes, 30 to 59 minutes, 1 to 11 hours, 12 to 23 hours, 1
to 3 days, 4 to 6 days, 1 week to 1 month, or >1 month. Health logs were
obtained from a randomly selected 5% sample of reporting high schools to verify
what they report on the surveillance system, and each year the data was
considered very accurate. Most of the concussions occurred in football (58%).
The next most common contributors were girls’ soccer (10%) and girls’
basketball (7%). Most athletes with concussions reported 4 or more symptoms at
the time of injury (61%). Some athletes reported 3 symptoms (20%), but very few
reported 2 (14%) or just 1 (5%) symptoms at the time of injury. Athletes presenting
with 4 or more symptoms were 2 times more likely to have concussion symptoms ≥ 1
week in both football and non-football sports. Furthermore, athletes that
reported feeling drowsy, nausea, or confusion with concentration difficulties at
the time of the injury were more likely to have concussion symptoms ≥ 1 week in
all sports. Concentration difficulties (without confusion) were associated with
a 2.3-fold greater risk for concussion symptoms lasting ≥ 1 week in football
players. Finally, sensitivity to both light and noise was associated with a
2.7-fold increase of risk for concussive symptoms lasting ≥ 1 week in
non-football players but not in football players.
Researchers
found that there are concussion symptoms at the time of an injury that may predict
who is at risk for a longer duration of the symptoms (e.g., drowsiness, nausea).
Interestingly, some risk factors were different for football players compared
to non-football players. The authors also found that having 4 or more symptoms
at the time of injury was associated with greater risk of symptoms lasting ≥ 1
week. However, this could be due to the severity of injury, where the more
severe injury would seem to take longer time to recover. Some of the specific
symptoms found to increase risk of a longer recovery of symptoms were
drowsiness, difficulty concentrating, and sensitivity to light and noise. Drowsiness has been previously shown to be a predictive factor of a severe brain injury. Future
research may want to investigate these symptoms further to confirm if they are
truly predictive of longer recovery of symptoms because this could improve
concussion guidelines and safety. What symptoms after a concussion have you
suspected might predict who will have a slower recovery of symptoms? Why do you
think there is a difference in concussion symptoms in football players compared
to non-football players?
found that there are concussion symptoms at the time of an injury that may predict
who is at risk for a longer duration of the symptoms (e.g., drowsiness, nausea).
Interestingly, some risk factors were different for football players compared
to non-football players. The authors also found that having 4 or more symptoms
at the time of injury was associated with greater risk of symptoms lasting ≥ 1
week. However, this could be due to the severity of injury, where the more
severe injury would seem to take longer time to recover. Some of the specific
symptoms found to increase risk of a longer recovery of symptoms were
drowsiness, difficulty concentrating, and sensitivity to light and noise. Drowsiness has been previously shown to be a predictive factor of a severe brain injury. Future
research may want to investigate these symptoms further to confirm if they are
truly predictive of longer recovery of symptoms because this could improve
concussion guidelines and safety. What symptoms after a concussion have you
suspected might predict who will have a slower recovery of symptoms? Why do you
think there is a difference in concussion symptoms in football players compared
to non-football players?
Written
by: Jane McDevitt MS, ATC, CSCS
by: Jane McDevitt MS, ATC, CSCS
Reviewed
by: Jeffrey Driban
by: Jeffrey Driban
Related Posts:
Chrisman SP, Rivara FP, Schiff MA, Zhou C, & Comstock RD (2013). Risk factors for concussive symptoms 1 week or longer in high school athletes. Brain Injury, 27 (1), 1-9 PMID: 23252433