Research Reports - Risk factors for prolonged symptoms of mild traumatic brain injury

Clin J Sport Med. 2017 Oct 26. doi: 10.1097/JSM.0000000000000494. [Epub ahead of
print]

Fehr SD(1), Nelson LD, Scharer KR, Traudt EA, Veenstra JM, Tarima SS, Liu XC,
Walter KD.

OBJECTIVE: To examine predictors of prolonged symptom duration from mild
traumatic brain injury (mTBI) in a pediatric sports medicine specialty clinic
cohort as these predictors may be distinct in this population.
DESIGN: Retrospective chart review.
SETTING: Outpatient specialty clinic.
PATIENTS: Charts of 549 patients (age range: 10-18 years) with concussions were
reviewed in an outpatient clinic that predominantly managed sports-related
injuries (77.3%). Patients (n = 431) included in the final analysis met the
criteria for mTBI and were symptomatic at their first visit.
ASSESSMENT OF RISK FACTORS: Patient history, injury, and recovery variables were
evaluated.
MAIN OUTCOME MEASURES: Predictors of prolonged time to reach self-reported
symptom recovery were evaluated using Cox proportional hazards.
RESULTS: Median time to symptom recovery of the 431 patients who presented to
clinic with symptoms was 40 days (full clinic sample median = 34 days). Analyses
identified 3 unique predictors of symptom recovery: loss of consciousness (LOC)
[hazard ratio (HR) = 0.56, P < 0.0001], female sex (HR = 0.57, P < 0.0001), and
concussion symptom score at first clinic visit (HR = 0.76, P < 0.0001).
CONCLUSIONS: Prolonged duration of mTBI symptoms in patients who present to a
pediatric sports-based concussion clinic is related to initial symptom severity,
female sex, and LOC.
 

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