Research Reports - Initial symptom burden predicts duration of symptoms after concussion

J Sci Med Sport. 2015 Dec 12. pii: S1440-2440(15)00235-2. doi:
10.1016/j.jsams.2015.12.002. [Epub ahead of print]

Meehan WP 3rd(1), O'Brien MJ(2), Geminiani E(3), Mannix R(4).

OBJECTIVES: To determine which variables predict prolonged (>28 days) duration of
symptoms after a concussion.
DESIGN: We conducted a prospective cohort study of adult (>18yo) patients cared
for in a specialty concussion clinic.
METHODS: Symptoms were assessed using the Post-Concussion Symptom Scale (PCSS)
developed at the 3rd International Conference on Concussion in Sports. Possible
predictors including age, sex, loss of consciousness, amnesia, history of prior
concussion, prior treatment for headaches, history of migraines, and family
history of concussions, were measured by self-report. We recorded a PCSS score at
each clinical visit and defined time to symptom resolution as the number of days
between the date of injury and date of last symptoms.
RESULTS: Of 64 adult patients included in the study, 53.3% were male; 20.3%
reported experiencing a loss of consciousness at the time of injury while 23.4%
reported amnesia. Patients ranged in age from 18 to 27 years (mean 21±2 years).
Most concussions (92.2%) occurred during sports. The mean initial PCSS score for
those suffering symptoms for longer than 28 days was significantly higher than
those who symptoms resolved within 28 days (42.5 vs. 19.2, p<0.01). Of all
potential predictor variables, only the initial PCSS score was independently
associated with the odds of symptoms lasting longer than 28 days (aOR 1.037; 95%
CI 1.011, 1.063).
CONCLUSIONS: Among adult patients with concussions, those with a higher symptom
burden after injury have an increased odds of suffering from prolonged symptoms.
Other potential predictor variables are not associated with the risk of prolonged
recovery. 

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