The cost of a single concussion in American high school football: a retrospective cohort study

Yengo‐Kahn, Aaron M.; Kelly, Patrick; Liles, David C.; McKeithan, Lydia; Grisham, Candace J.; Khan, Muhammad Saad; Lee, Timothy J.; Kuhn, Andrew W; Bonfield, Christopher M.; Zuckerman, Scott L.

doi:10.2217/cnc-2020-0012

Cited by 14 publications

(7 citation statements)

References 47 publications

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“…Therefore, adolescents who experience multiple concussions may not only delay their return to sport and daily life but also increase health care costs because of the need for additional treatment. 30 The insignificant difference in recovery time between Concussion 1 and Concussion 2 likely reflects the small sample size within our secondary analysis. Even though the secondary analysis sample size was small, the main analysis population represented the typical pediatric concussion population: most concussions were sport-related, the proportion of sexes was evenly split, and the incidence of PPCS was approximately 30%, which is consistent with the risk for adolescents reported in the prospective concussion literature.…”

Section: Discussionmentioning

confidence: 91%

Association of Concussion History and Prolonged Recovery in Youth

Chizuk

Cunningham

Horn

et al. 2022

Clinical Journal of Sport Medicine

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To determine the number of prior concussions associated with increased incidence of persistent postconcussive symptoms (PPCS) in a cohort of acutely concussed pediatric patients. Design: Prospective observational cohort study. Setting: Three university-affiliated concussion clinics. Participants: Two hundred seventy participants (14.9 6 1.9 years, 62% male, 54% with prior concussion) were assessed within 14 days of concussion and followed to clinical recovery. Participants with a second head injury before clinical recovery were excluded. Measures: and Main Outcome: Concussion history, current injury characteristics, recovery time, and risk for prolonged recovery from current concussion. Results: There was no statistically significant change in PPCS risk for participants with 0, 1 or 2 prior concussions; however, participants with 3 or more prior concussions had a significantly greater risk of PPCS. Twelve participants sustained a subsequent concussion after clinical recovery from their first injury and were treated as a separate cohort. Our secondary analysis found that these participants took longer to recover and had a greater incidence of PPCS during recovery from their latest concussion. Conclusion: Pediatric patients with a history of 3 or more concussions are at greater risk of PPCS than those with fewer than 3 prior concussions.

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Section: Discussionmentioning

confidence: 91%

Association of Concussion History and Prolonged Recovery in Youth

Chizuk

Cunningham

Horn

et al. 2022

Clinical Journal of Sport Medicine

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“…Current concussion consensus statements recommend a multi-faceted approach to concussion management (3), particularly in pediatric patients due to an increased vulnerability to injury (4), longer average recovery (5), and the inclusion of additional stakeholders (i.e., school nurses, teachers, parents) (5) relative to adult patients. Additionally, active rehabilitation programs, including vision and vestibular therapies, are recommended for the treatment of adolescent concussion (3,(6)(7)(8); however, barriers to specialized concussion care, including financial barriers (9,10), access to health care (11), or socioeconomic health disparities (12)(13)(14), prevent patients from accessing the relevant concussion care to optimize their recovery. There is a need to further explore cost-effective and equitable approaches to active concussion management in a pediatric population.…”

Section: Introductionmentioning

confidence: 99%

The effect of a home exercise program on visio-vestibular function in concussed pediatric patients

Roby

Podolak²,

Grady³

et al. 2023

Front. Sports Act. Living

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BackgroundA visio-vestibular home exercise program (VV-HEP) can provide an equitable and cost-effective method for therapy targeted towards visio-vestibular deficits that are common following concussion. The effects of a VV-HEP on improving concussion symptoms and visio-vestibular function are unclear.PurposeDetermine the effect of VV-HEP on symptoms and visio-vestibular function in concussed pediatric patients.MethodsThis study included 527 patients [294 female (55.8%); age = 14.4 ± 2.1 years] reporting to a specialty care concussion center within 28 days of injury and for a first follow-up within 60 days of injury. Patients completed the Post-Concussion Symptom Inventory (PCSI) and Visio-Vestibular Examination (VVE). Patients were prescribed the VV-HEP at initial visit, with exercises including saccades, gaze stability, convergence, and balance, and instructed to complete these 1–2 times/day. At follow-up, patients self-reported their VV-HEP progress as (1) has not done, (2) in progress, or (3) completed. Primary outcomes included VV-HEP progress at follow-up, PCSI endorsement and severity, VVE subtests (normal/abnormal), and total VVE score (abnormal = 2 + abnormal subtests). Kruskal-Wallis tests and chi-square were used to determine if concussion symptoms or the proportion of abnormal VVE outcomes, respectively, were associated with VV-HEP status. Post-hoc pairwise comparisons with Bonferonni corrections were used to determine concussion symptom (α = 0.017 a priori) and VVE (α = 0.005 a priori) differences in VV-HEP status.ResultsAt follow-up, patients who had completed the VV-HEP reported lower symptom endorsement (median = 1, IQR = 0–3) and lower symptom severity (median = 1, IQR = 0–4) relative to patients who had not started the VV-HEP (endorsement median = 7, IQR = 1–13, p < 0.0001; severity median = 15.5, IQR = 2–32.5, p < 0.0001) and those in progress (endorsement median = 8, IQR = 3–14, p < 0.0001; severity median = 15, IQR = 4–30, p < 0.0001). A lower proportion of patients who completed the VV-HEP reported with abnormal vestibular-ocular reflex (22.2%), tandem gait (0%), and total VVE score (22.2%) relative to those who had not started or those in progress (p < 0.005).ConclusionOur findings indicate that patients who completed the VV-HEP had lower symptom burden and improved visio-vestibular function relative to those who did not start or were in progress. This suggests that a VV-HEP can effectively reduce visio-vestibular dysfunction following concussion and may serve as a means to minimize inequities in access to care.

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“…Mild traumatic brain injury (mTBI), known colloquially as concussion, continues to be a major health concern in the United States due to the high incidence and expense burden on the healthcare system. Traumatic brain injuries account for approximately 2.5 million emergency department visits annually, with an average cost of $800 per concussion [ 1 , 2 ]. As many as 5.3 million Americans suffer prolonged disability as a result of such injuries [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

The Potential Role of Neurofilament Light in Mild Traumatic Brain Injury Diagnosis: A Systematic Review

Farragher¹,

Ku²,

Powers³

2022

Cureus

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Mild traumatic brain injury (mTBI) is an insult to the CNS often overlooked at the time of presentation due to variable symptomatology and undetectable nature on CT/MRI. Increased exposure to repetitive head injuries results in a high prevalence of mTBI among athletes and military personnel. While most patients fully recover with rest, some are at risk for long-lasting neurocognitive dysfunction, leading to a high morbidity and cost burden on the healthcare system. Currently, there are no unified symptom-based criteria or gold standard objective measurement for mTBI. Neurofilament light (Nf-L) is a highly sensitive biomarker for axonal injury with the potential to serve as an objective serum measurement for mTBI. This systematic review investigates the ability of Nf-L to accurately diagnose acute mTBI in athletes and military personnel.A comprehensive literature search of PubMed, Scopus, and Google Scholar from 2010 to 2021 using keywords neurofilament light chain, mTBI, concussion, athletes, and military identified 239 articles for eligibility screening. Ten articles met the inclusion criteria for qualitative analysis, with extracted data including Nf-L levels, recovery characteristics, and neuroimaging results. Of the 10 studies meeting inclusion criteria, one was military-related, five were sports-related, and four were mixed-focus. Six studies investigated the association between mTBI and Nf-L levels within 24 hours of injury. Four of these studies involved athletes, with three showing evidence of acute Nf-L elevations. No evidence of acute Nf-L elevations was reported among military personnel or emergency department patients. Nf-L elevations were recorded at various time points greater than 24 hours post-injury in athletes (two studies) and emergency department patients (one study). Positive associations were found between Nf-L levels and loss of consciousness/post-traumatic amnesia (one study), positive neuroimaging findings (three studies), and prolonged recovery times (three studies).We are unable to conclude whether Nf-L has the capacity for acute diagnosis of mTBI or the optimal time for serum measurement. Nf-L does, however, shows promise as a prognostic factor for mTBI complications, neuroimaging findings, and recovery. Additional studies are warranted, as the use of Nf-L in early diagnosis of mTBI in the future would improve clinical management while decreasing complications and healthcare costs.

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The cost of a single concussion in American high school football: a retrospective cohort study

Cited by 14 publications

References 47 publications

Association of Concussion History and Prolonged Recovery in Youth

Association of Concussion History and Prolonged Recovery in Youth

The effect of a home exercise program on visio-vestibular function in concussed pediatric patients

The Potential Role of Neurofilament Light in Mild Traumatic Brain Injury Diagnosis: A Systematic Review

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