Chad A Asplund1, Douglas B McKeag, Cara H Olsen. 1. Department of Family Practice, DeWitt Army Community Hospital, Fort Belvoir, VA 22060, USA. chad.asplund@us.army.mil
Abstract
OBJECTIVE: To assess predictive value of concussion signs and symptoms based on return-to-play timelines. DESIGN: Physician practice study without diagnosis that includes presentation, initial and subsequent treatment, and management of concussion. SETTING: National multisite primary care sports medicine provider locations. PARTICIPANTS: Twenty-two providers at 18 sites; 101 athletes (91 men, 10 women in the following sports: 73 football, 8 basketball, 8 soccer, 3 wrestling, 2 lacrosse, 2 skiing, 5 others; 51 college, 44 high school, 4 professional, and 2 recreational). MAIN OUTCOME MEASUREMENTS: Duration of symptoms, presence of clinical signs, and time to return to play following concussion. RESULTS: One hundred one concussions were analyzed. Pearson chi2 analysis of common early and late concussion symptoms revealed statistical significance (P < 0.05) of headache >3 hours, difficulty concentrating >3 hours, any retrograde amnesia or loss of consciousness, and return to play >7 days. There appeared to be a trend in patients with posttraumatic amnesia toward poor outcome, but this was not statistically significant. CONCLUSIONS: When evaluating concussion, symptoms of headache >3 hours, difficulty concentrating >3 hours, retrograde amnesia, or loss of consciousness may indicate a more severe injury or prolonged recovery; great caution should be exercised before returning these athletes to play.
OBJECTIVE: To assess predictive value of concussion signs and symptoms based on return-to-play timelines. DESIGN: Physician practice study without diagnosis that includes presentation, initial and subsequent treatment, and management of concussion. SETTING: National multisite primary care sports medicine provider locations. PARTICIPANTS: Twenty-two providers at 18 sites; 101 athletes (91 men, 10 women in the following sports: 73 football, 8 basketball, 8 soccer, 3 wrestling, 2 lacrosse, 2 skiing, 5 others; 51 college, 44 high school, 4 professional, and 2 recreational). MAIN OUTCOME MEASUREMENTS: Duration of symptoms, presence of clinical signs, and time to return to play following concussion. RESULTS: One hundred one concussions were analyzed. Pearson chi2 analysis of common early and late concussion symptoms revealed statistical significance (P < 0.05) of headache >3 hours, difficulty concentrating >3 hours, any retrograde amnesia or loss of consciousness, and return to play >7 days. There appeared to be a trend in patients with posttraumatic amnesia toward poor outcome, but this was not statistically significant. CONCLUSIONS: When evaluating concussion, symptoms of headache >3 hours, difficulty concentrating >3 hours, retrograde amnesia, or loss of consciousness may indicate a more severe injury or prolonged recovery; great caution should be exercised before returning these athletes to play.
Authors: Kathryn L Van Pelt; C Dain Allred; Rachel Brodeur; Kenneth L Cameron; Darren E Campbell; Christopher J D'Lauro; Xuming He; Megan N Houston; Brian R Johnson; Tim F Kelly; Gerald McGinty; Sean K Meehan; Patrick G O'Donnell; Karen Y Peck; Steven J Svoboda; Paul Pasquina; Thomas McAllister; Michael McCrea; Steven P Broglio Journal: J Athl Train Date: 2020-07-01 Impact factor: 2.860
Authors: Michael W Collins; Anthony P Kontos; David O Okonkwo; Jon Almquist; Julian Bailes; Mark Barisa; Jeffrey Bazarian; O Josh Bloom; David L Brody; Robert Cantu; Javier Cardenas; Jay Clugston; Randall Cohen; Ruben Echemendia; R J Elbin; Richard Ellenbogen; Janna Fonseca; Gerard Gioia; Kevin Guskiewicz; Robert Heyer; Gillian Hotz; Grant L Iverson; Barry Jordan; Geoffrey Manley; Joseph Maroon; Thomas McAllister; Michael McCrea; Anne Mucha; Elizabeth Pieroth; Kenneth Podell; Matthew Pombo; Teena Shetty; Allen Sills; Gary Solomon; Danny G Thomas; Tamara C Valovich McLeod; Tony Yates; Ross Zafonte Journal: Neurosurgery Date: 2016-12 Impact factor: 4.654
Authors: Leah J Frommer; Kelly K Gurka; Kevin M Cross; Christopher D Ingersoll; R Dawn Comstock; Susan A Saliba Journal: J Athl Train Date: 2011 Jan-Feb Impact factor: 2.860
Authors: Benjamin L Brett; Mark D Kramer; Michael A McCrea; Steven P Broglio; Thomas W McAllister; Lindsay D Nelson; Joseph B Hazzard; Louise A Kelly; Justus Ortega; Nicholas Port; Paul F Pasquina; Jonathan Jackson; Kenneth L Cameron; Megan N Houston; Joshua T Goldman; Christopher Giza; Thomas Buckley; James R Clugston; Julianne D Schmidt; Luis A Feigenbaum; James T Eckner; Christina L Master; Michael W Collins; Anthony P Kontos; Sara P D Chrisman; Stefan M Duma; Christopher M Miles; Adam Susmarski Journal: Am J Sports Med Date: 2020-08-18 Impact factor: 6.202
Authors: April L McPherson; Matthew B Shirley; Nathan D Schilaty; Dirk R Larson; Timothy E Hewett Journal: Sports Med Date: 2020-06 Impact factor: 11.136