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Multisymptoms increased risk for extended duration of concussive symptoms in prep athletes
High school athletes who presented with four or more symptoms after sustaining concussion had a greater risk for those symptoms lasting for at least 7 days, according to recent study results.
Using data from the National High School Sports-Related Injury Surveillance System Reporting Information Online, researchers conducted a retrospective cohort study of concussions that occurred from fall 2006 through spring 2009. The data included 1,412 concussions, with 77.1% occurring among males and 57.9% of incidents sustained during football.
Sara P.D. Chrisman
“Our goal was to identify specific symptoms that predicted more severe concussive injury, so that these symptoms might be used to stratify risk in the design of the new return-to-play guidelines,” researcher Sara P.D. Chrisman, MD, MPH, acting assistant professor, adolescent medicine, University of Washington, told Healio.com.
The majority of athletes (60.8%) reported four or more symptoms of concussion, with headache (95.6%) and dizziness (79%) being the most common signs. Chrisman said athletes who presented with drowsiness, nausea, concentration difficulties, and sensitivity to light and noise appeared to be at greater risk for having concussive symptoms that lasted longer than 1 week.
Using stratified analysis, football players (n=817) had twice the associated risk for symptoms lasting for 7 days or more (RR=2.1; 95% CI, 1.3-3.5), while nonfootball players (n=595) had similar extended risk (RR=2.5; 95% CI, 1.4-4.6) when presenting with four or more symptoms.
Only football players showed an association between previous concussions and concussive symptoms lasting for more than 1 week (RR=2.1; 95% CI, 1.3-3.5). Sensitivity to light and noise was associated with symptoms extending at least 7 days among nonfootball players (RR=2.7; 95% CI, 1.5-4.5).
“Historically loss of consciousness was thought to be associated with concussion severity, but we did not find an association between loss of consciousness and persistent symptoms in our data,” Chrisman said.
“Risk factors for concussive symptoms of 1 week or more are identifiable and can potentially be used to prognosticate for athletes and design evidence-based return-to-play guidelines,” the researchers concluded.