Cargando…

Demographic, Injury Characteristics, and Comorbidity Differences Between Youth with >28 Day and >90 Day Recovery from Concussion

BACKGROUND: The identification and comparison of risk factors between concussed children with symptom resolution >28 days and those with symptom resolution >90 days may aid in clinical care. PURPOSE: The objective of this study was to identify demographic, comorbidity, and injury factors assoc...

Descripción completa

Detalles Bibliográficos
Autores principales: Young, Julie A., Maki, Aaron, Feiss, Robyn, Yang, Jinzhen, Cuff, Steven C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9112686/
http://dx.doi.org/10.1177/2325967121S00397
_version_ 1784709460650885120
author Young, Julie A.
Maki, Aaron
Feiss, Robyn
Yang, Jinzhen
Cuff, Steven C.
author_facet Young, Julie A.
Maki, Aaron
Feiss, Robyn
Yang, Jinzhen
Cuff, Steven C.
author_sort Young, Julie A.
collection PubMed
description BACKGROUND: The identification and comparison of risk factors between concussed children with symptom resolution >28 days and those with symptom resolution >90 days may aid in clinical care. PURPOSE: The objective of this study was to identify demographic, comorbidity, and injury factors associated with prolonged (>28 days) and extended (>90 days) concussion recovery among children aged 10 to 18 years with concussions. METHODS: Demographics, injury characteristics and comorbidities were recorded in patients aged 10-18. We assessed the associations of patients’ demographics, comorbidities, and injury characteristics with the outcome variable of concussion symptom resolution >28 days post-injury using two-level, Generalized Linear Mixed model (GLMM). We repeated the analysis for concussion symptom resolution >90 days post-injury. Odds ratios(OR) and 95% confidence intervals(CI) were reported. RESULTS: A total of 4,937 concussions were analyzed. Of these, 32.6% had resolution >28 days and an additional 20.1% had resolution >90 days after injury. Risk factors for symptom resolution >28 days included female sex, (OR=1.22, 95% CI=1.03, 1.44), ADD/ADHD diagnosis (OR=1.31, 95% CI=1.00, 1.72), those with one (OR=1.41, 95% CI=1.17, 1.71), two (OR=1.41, 95% CI=1.02, 1.95), or three or more previous concussions (OR=2.08, 95% CI=1.42, 3.05), higher initial symptom score (OR=1.04, 95% CI=1.04, 1.05), and greater days from injury to first visit (OR=2.80, 95% CI=2.53, 3.09). Risk factors for >90 days to recovery included older age group (OR=1.66, 95% CI=1.18, 2.32) in 15-18 year olds compared to 10-14 year olds, two (OR=1.84, 95% CI=1.10, 3.07), or three or more (OR=2.30, 95% CI=1.27, 4.19) previous concussions, history of headaches (OR=0.65, 95% CI=0.46, 0.93), anxiety disorder diagnosis (OR=1.66, 95% CI=1.04, 2.64), higher symptom scores at first visit, (OR=1.01, 95% CI=1.00-1.01), and a greater number of days from injury to first visit (OR=1.29, 95% CI=1.20-1.39). DISCUSSION: Female sex and ADD/ADHD diagnosis were unique risk factors for >28 day recovery and history of headaches, anxiety diagnosis, and age were unique risk factors for >90 day recovery. For both groups, higher initial symptom scores and longer time to initial evaluation resulted in longer recovery. Future studies are needed to screen and detect children at risk for prolonged recovery during the acute phase post-injury so that appropriate clinical care can be provided to expedite concussion recovery.
format Online
Article
Text
id pubmed-9112686
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-91126862022-05-18 Demographic, Injury Characteristics, and Comorbidity Differences Between Youth with >28 Day and >90 Day Recovery from Concussion Young, Julie A. Maki, Aaron Feiss, Robyn Yang, Jinzhen Cuff, Steven C. Orthop J Sports Med Article BACKGROUND: The identification and comparison of risk factors between concussed children with symptom resolution >28 days and those with symptom resolution >90 days may aid in clinical care. PURPOSE: The objective of this study was to identify demographic, comorbidity, and injury factors associated with prolonged (>28 days) and extended (>90 days) concussion recovery among children aged 10 to 18 years with concussions. METHODS: Demographics, injury characteristics and comorbidities were recorded in patients aged 10-18. We assessed the associations of patients’ demographics, comorbidities, and injury characteristics with the outcome variable of concussion symptom resolution >28 days post-injury using two-level, Generalized Linear Mixed model (GLMM). We repeated the analysis for concussion symptom resolution >90 days post-injury. Odds ratios(OR) and 95% confidence intervals(CI) were reported. RESULTS: A total of 4,937 concussions were analyzed. Of these, 32.6% had resolution >28 days and an additional 20.1% had resolution >90 days after injury. Risk factors for symptom resolution >28 days included female sex, (OR=1.22, 95% CI=1.03, 1.44), ADD/ADHD diagnosis (OR=1.31, 95% CI=1.00, 1.72), those with one (OR=1.41, 95% CI=1.17, 1.71), two (OR=1.41, 95% CI=1.02, 1.95), or three or more previous concussions (OR=2.08, 95% CI=1.42, 3.05), higher initial symptom score (OR=1.04, 95% CI=1.04, 1.05), and greater days from injury to first visit (OR=2.80, 95% CI=2.53, 3.09). Risk factors for >90 days to recovery included older age group (OR=1.66, 95% CI=1.18, 2.32) in 15-18 year olds compared to 10-14 year olds, two (OR=1.84, 95% CI=1.10, 3.07), or three or more (OR=2.30, 95% CI=1.27, 4.19) previous concussions, history of headaches (OR=0.65, 95% CI=0.46, 0.93), anxiety disorder diagnosis (OR=1.66, 95% CI=1.04, 2.64), higher symptom scores at first visit, (OR=1.01, 95% CI=1.00-1.01), and a greater number of days from injury to first visit (OR=1.29, 95% CI=1.20-1.39). DISCUSSION: Female sex and ADD/ADHD diagnosis were unique risk factors for >28 day recovery and history of headaches, anxiety diagnosis, and age were unique risk factors for >90 day recovery. For both groups, higher initial symptom scores and longer time to initial evaluation resulted in longer recovery. Future studies are needed to screen and detect children at risk for prolonged recovery during the acute phase post-injury so that appropriate clinical care can be provided to expedite concussion recovery. SAGE Publications 2022-05-13 /pmc/articles/PMC9112686/ http://dx.doi.org/10.1177/2325967121S00397 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For article reuse guidelines, please visit SAGE’s website at http://www.sagepub.com/journals-permissions.
spellingShingle Article
Young, Julie A.
Maki, Aaron
Feiss, Robyn
Yang, Jinzhen
Cuff, Steven C.
Demographic, Injury Characteristics, and Comorbidity Differences Between Youth with >28 Day and >90 Day Recovery from Concussion
title Demographic, Injury Characteristics, and Comorbidity Differences Between Youth with >28 Day and >90 Day Recovery from Concussion
title_full Demographic, Injury Characteristics, and Comorbidity Differences Between Youth with >28 Day and >90 Day Recovery from Concussion
title_fullStr Demographic, Injury Characteristics, and Comorbidity Differences Between Youth with >28 Day and >90 Day Recovery from Concussion
title_full_unstemmed Demographic, Injury Characteristics, and Comorbidity Differences Between Youth with >28 Day and >90 Day Recovery from Concussion
title_short Demographic, Injury Characteristics, and Comorbidity Differences Between Youth with >28 Day and >90 Day Recovery from Concussion
title_sort demographic, injury characteristics, and comorbidity differences between youth with >28 day and >90 day recovery from concussion
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9112686/
http://dx.doi.org/10.1177/2325967121S00397
work_keys_str_mv AT youngjuliea demographicinjurycharacteristicsandcomorbiditydifferencesbetweenyouthwith28dayand90dayrecoveryfromconcussion
AT makiaaron demographicinjurycharacteristicsandcomorbiditydifferencesbetweenyouthwith28dayand90dayrecoveryfromconcussion
AT feissrobyn demographicinjurycharacteristicsandcomorbiditydifferencesbetweenyouthwith28dayand90dayrecoveryfromconcussion
AT yangjinzhen demographicinjurycharacteristicsandcomorbiditydifferencesbetweenyouthwith28dayand90dayrecoveryfromconcussion
AT cuffstevenc demographicinjurycharacteristicsandcomorbiditydifferencesbetweenyouthwith28dayand90dayrecoveryfromconcussion