Neurocognitive and Symptom Predictors of Recovery in High School Athletes

Lau, Bjørn; Lovell, Mark R.; Collins, Michael W.; Pardini, Jamie E.

doi:10.1097/jsm.0b013e31819d6edb

Cited by 202 publications

(178 citation statements)

References 10 publications

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“…This finding is consistent with others reported in the literature 21,22,27,28 and suggests that more conservative or precautionary measures should be taken in the presence of such factors.…”

Section: Discussionsupporting

confidence: 93%

“…A 10-day time loss cut-point was used as a marker to retrospectively distinguish concussion severity (≤ 10 v. > 10 days); this marker has been supported in the literature for adult male sport participants. 3,[20][21][22][23] Multivariable logistic regression was fitted, adjusting for age (in years) and position (i.e., centre, wing, defense or goalie). Sensitivity analysis was also performed by treating time loss (in days) as a continuous outcome.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A prospective study of concussions among National Hockey League players during regular season games: the NHL-NHLPA Concussion Program

Benson¹,

Meeuwisse²,

Rizos³

et al. 2011

Canadian Medical Association Journal

173

126

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

A prospective study of concussions among National Hockey League players during regular season games: the NHL-NHLPA Concussion Program

Benson¹,

Meeuwisse²,

Rizos³

et al. 2011

Canadian Medical Association Journal

173

126

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“…18 A 10-day cut-off for time loss due to concussion was chosen because it has been suggested as a marker to retrospectively distinguish severity of concussion and has been supported in the literature for male sport participants. 16,[20][21][22][23][24] Statistical analysis Baseline characteristics were compared between the two study cohorts and between injured and uninjured players.…”

Section: Outcome Measuresmentioning

confidence: 99%

Risk of injury associated with bodychecking experience among youth hockey players

Emery¹,

Kang²,

Shrier³

et al. 2011

Canadian Medical Association Journal

120

114

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“…23,57,62 Also associated with a higher likelihood of PCS after mild traumatic brain injury (mTBI) in youth are immediate postinjury amnesia, loss of consciousness, confusion, migraine headache, photophobia, phonophobia, and poor cognition. 15,16,33,35,38,43 However, even these findings have been disputed; the association depends on whether the mTBI was sport related. 50 Demographic risk factors have also been studied.…”

mentioning

confidence: 99%

Predictors of postconcussion syndrome after sports-related concussion in young athletes: a matched case-control study

Morgan

Zuckerman

Lee

et al. 2015

PED

217

156

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OBJECT Sport-related concussion (SRC) is a major public health problem. Approximately 90% of SRCs in high school athletes are transient; symptoms recover to baseline within 1 week. However, a small percentage of patients remain symptomatic several months after injury, with a condition known as postconcussion syndrome (PCS). The authors aimed to identify risk factors for PCS development in a cohort of exclusively young athletes (9–18 years of age) who sustained SRCs while playing a sport. METHODS The authors conducted a retrospective case-control study by using the Vanderbilt Sports Concussion Clinic database. They identified 40 patients with PCS and matched them by age at injury and sex to SRC control patients (1 PCS to 2 control). PCS patients were those experiencing persistent symptoms at 3 months after an SRC. Control patients were those with documented resolution of symptoms within 3 weeks of an SRC. Data were collected in 4 categories: 1) demographic variables; 2) key medical, psychiatric, and family history; 3) acute-phase postinjury symptoms (at 0–24 hours); and 4) subacute-phase postinjury features (at 0–3 weeks). The chi-square Fisher exact test was used to assess categorical variables, and the Mann-Whitney U-test was used to evaluate continuous variables. Forward stepwise regression models (Pin = 0.05, Pout = 0.10) were used to identify variables associated with PCS. RESULTS PCS patients were more likely than control patients to have a concussion history (p = 0.010), premorbid mood disorders (p = 0.002), other psychiatric illness (p = 0.039), or significant life stressors (p = 0.036). Other factors that increased the likelihood of PCS development were a family history of mood disorders, other psychiatric illness, and migraine. Development of PCS was not predicted by race, insurance status, body mass index, sport, helmet use, medication use, and type of symptom endorsement. A final logistic regression analysis of candidate variables showed PCS to be predicted by a history of concussion (OR 1.8, 95% CI 1.1–2.8, p = 0.016), preinjury mood disorders (OR 17.9, 95% CI 2.9–113.0, p = 0.002), family history of mood disorders (OR 3.1, 95% CI 1.1–8.5, p = 0.026), and delayed symptom onset (OR 20.7, 95% CI 3.2–132.0, p < 0.001). CONCLUSIONS In this age- and sex-matched case-control study of risk factors for PCS among youth with SRC, risk for development of PCS was higher in those with a personal and/or family history of mood disorders, other psychiatric illness, and migraine. These findings highlight the unique nature of SRC in youth. For this population, providers must recognize the value of establishing the baseline health and psychiatric status of children and their primary caregivers with regard to symptom reporting and recovery expectations. In addition, delayed symptom onset was an unexpected but strong risk factor for PCS in this cohort. Delayed symptoms could potentially result in late removal from play, rest, and care by qualified health care professionals. Taken together, these results may help practitioners identify young athletes with concussion who are at a greater danger for PCS and inform larger prospective studies for validation of risk factors from this cohort.

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Neurocognitive and Symptom Predictors of Recovery in High School Athletes

Abstract: Specific symptom clusters and neurocognitive test results may have predictive value to classifying and managing concussions.

Cited by 202 publications

References 10 publications

A prospective study of concussions among National Hockey League players during regular season games: the NHL-NHLPA Concussion Program

A prospective study of concussions among National Hockey League players during regular season games: the NHL-NHLPA Concussion Program

Risk of injury associated with bodychecking experience among youth hockey players

Predictors of postconcussion syndrome after sports-related concussion in young athletes: a matched case-control study

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