Author
Abstract
<p><b>OBJECTIVE: </b>To identify pre-existing characteristics associated with prolonged recovery from concussion in a sample of patients referred to a pediatric sports medicine clinic.</p>
<p><b>STUDY DESIGN: </b>This was a retrospective, exploratory cohort study of 247 patients age 5-18&nbsp;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.</p>
<p><b>RESULTS: </b>The median time until returning to school part-time was 12&nbsp;days (IQR 6-21); until returning to school full-time without accommodations was 35&nbsp;days (IQR 11-105); until becoming symptom-free was 64&nbsp;days (IQR 18-119); and until being fully cleared to return to sports was 75&nbsp;days (IQR 30-153). Furthermore, 73% of all patients were symptomatic for &gt;4&nbsp;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.</p>
<p><b>CONCLUSIONS: </b>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.</p>
Year of Publication
2014
Journal
J Pediatr
Volume
165
Issue
6
Number of Pages
1207-15
Date Published
2014 Dec
ISSN Number
1097-6833
DOI
10.1016/j.jpeds.2014.08.034
Alternate Journal
J. Pediatr.
PMID
25262302