Faculty Collaboration Database

Risk Factors for Prolonged Symptoms of Mild Traumatic Brain Injury: A Pediatric Sports Concussion Clinic Cohort. Clin J Sport Med 2019 Jan;29(1):11-17

Date

10/31/2017

Pubmed ID

29084034

DOI

10.1097/JSM.0000000000000494

Scopus ID

2-s2.0-85056245604 (requires institutional sign-in at Scopus site)   51 Citations

Abstract

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.

Author List

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

Authors

Shayne Fehr MD Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
Xue-Cheng Liu PhD Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
Lindsay D. Nelson PhD Professor in the Neurosurgery department at Medical College of Wisconsin
Sergey S. Tarima PhD Associate Professor in the Data Science Institute department at Medical College of Wisconsin
Kevin D. Walter MD Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Ambulatory Care Facilities
Athletic Injuries
Brain Concussion
Child
Female
Humans
Male
Post-Concussion Syndrome
Retrospective Studies
Risk Factors
Time Factors
Youth Sports