Center for Injury Research and Prevention

Characteristics of prolonged concussion recovery in a pediatric subspecialty referral population.

TitleCharacteristics of prolonged concussion recovery in a pediatric subspecialty referral population.
Publication TypeJournal Article
Year of Publication2014
AuthorsCorwin DJ
Secondary AuthorsZonfrillo MR, Master CL, Arbogast KB, Grady MF, Robinson RL, Goodman AM, Wiebe DJ
JournalJ Pediatr
Volume165
Issue6
Pagination1207-15
Date Published2014 Dec
ISSN1097-6833
Keywordspediatric concussion
Abstract

OBJECTIVE: To identify pre-existing characteristics associated with prolonged recovery from concussion in a sample of patients referred to a pediatric sports medicine clinic.

STUDY DESIGN: This was a retrospective, exploratory cohort study of 247 patients age 5-18 years with concussion referred to a tertiary pediatric hospital-affiliated sports medicine clinic from July 1, 2010, through December 31, 2011. A random sample of all eligible patient visits (3740) was chosen for further review and abstraction. Statistical comparisons between subsets of patients were conducted using exact χ(2) tests, logistic regression, quantile regression, and Kaplan-Meier survival curves.

RESULTS: The median time until returning to school part-time was 12 days (IQR 6-21); until returning to school full-time without accommodations was 35 days (IQR 11-105); until becoming symptom-free was 64 days (IQR 18-119); and until being fully cleared to return to sports was 75 days (IQR 30-153). Furthermore, 73% of all patients were symptomatic for >4 weeks, 73% were prescribed some form of school accommodation, and 61% reported a decline in grades. Characteristics associated with a prolonged recovery included a history of depression or anxiety; an initial complaint of dizziness; abnormal convergence or symptom provocation following oculomotor examination on physical examination; and history of prior concussion.

CONCLUSIONS: Pediatric and adolescent patients with concussion may experience cognitive and emotional morbidity that can last for several months following injury. Clinicians should consider specific pre-existing characteristics and presenting symptoms that may be associated with a more complicated recovery for concussion patients.

DOI10.1016/j.jpeds.2014.08.034
Alternate JournalJ. Pediatr.
PubMed ID25262302
PubMed Central IDPMC4253594
Grant ListK08 HD073241 / HD / NICHD NIH HHS / United States