Multiple factors indicate need for additional care after concussion

A patient’s age, severity of symptoms, number of previous concussions and family history of psychiatric disorders were associated with a need for additional care before student athletes with concussion could return to play.

Douglas P. Terry, PhD, a neuropsychologist at the Sport Concussion Center at Vanderbilt University in Nashville, Tenn., and colleagues sought to identify variables associated with additional concussion clinic visits before a student athlete’s release to an athletic trainer. The researchers reported their findings in the Clinical Journal of Sports Medicine.

“Broadly speaking, 85% to 90% of student athletes take 3 weeks or less to clinically recover from their concussion and require minimal medical intervention,” the authors wrote.

Terry and colleagues conducted a retrospective cohort study among patients aged 12 to 23 years who presented with a sports-related concussion from Jan. 11, 2017, through Jan. 10, 2020, and were discharged to an athletic trainer.

The authors compared those who were discharged to an athletic trainer after their initial clinic visit with those who went to additional clinic visits before their release to a trainer. A patients’ age, sex, initial visit symptom score, family and personal history of psychiatric disorder and migraine, as well as history of prior concussion were assessed.

A total of 524 patients were included in the analysis — 236 were discharged after their initial clinic visit; 288 patients required additional clinic visits.

Of those who had additional clinic visits before their release, the researchers reported a higher initial symptom score, more frequent head imaging, a family history of psychiatric disorders or migraine, a younger age and more frequent concussions when compared with those who received just one clinic visit.

In a multiple variable model, family history of psychiatric disease (OR = 3.12; 95% CI, 1.53-6.34), prior concussions (OR = 1.39; 95% CI, 1.02-1.89), greater initial symptom score (OR = 1.05; 95% CI, 1.03-1.05) and younger age (OR = 0.87; 95% CI, 0.77-0.97) were strongly associated with additional visits, the authors reported.

“Optimal concussion care should reduce the chances of suffering long-term adverse consequences or entering return-to-play protocols prematurely,” Terry said in a press release from the journal’s publisher. “Knowledge of significant variables associated with additional clinic visits may contribute to better expectations understood by patients and their families during the recovery process.”

Reference:

Which student-athletes can be safely released to an athletic trainer after concussion? https://www.newswise.com/articles/which-student-athletes-can-be-safely-released-to-an-athletic-trainer-after-concussion?sc=dwhr&xy=10007438. Published Oct. 4, 2022. Accessed Oct. 13, 2022.