G Kyle Harrold1, Lisena Hasanaj1, Nicholas Moehringer1, Isis Zhang1, Rachel Nolan1, Liliana Serrano1, Jenelle Raynowska1, Janet C Rucker2, Steven R Flanagan3, Dennis Cardone4, Steven L Galetta2, Laura J Balcer5. 1. Department of Neurology, New York University School of Medicine, New York, NY, USA. 2. Department of Neurology, New York University School of Medicine, New York, NY, USA; Department of Ophthalmology, New York University School of Medicine, New York, NY, USA. 3. Department of Physical Medicine and Rehabilitation, New York University School of Medicine, New York, NY, USA. 4. Department of Primary Care Sports Medicine - Orthopaedics, New York University School of Medicine, New York, NY, USA. 5. Department of Neurology, New York University School of Medicine, New York, NY, USA; Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Ophthalmology, New York University School of Medicine, New York, NY, USA. Electronic address: laura.balcer@nyumc.org.
Abstract
OBJECTIVE: This study investigated the utility of sideline concussion tests, including components of the Sports Concussion Assessment Tool, 3rd Edition (SCAT3) and the King-Devick (K-D), a vision-based test of rapid number naming, in an outpatient, multidisciplinary concussion center treating patients with both sports-related and non-sports related concussions. The ability of these tests to predict clinical outcomes based on the scores at the initial visit was evaluated. METHODS: Scores for components of the SCAT3 and the K-D were fit into regression models accounting for age, gender, and sport/non-sport etiology in order to predict clinical outcome measures including total number of visits to the concussion center, whether the patient reached a SCAT3 symptom severity score≤7, and the total types of referrals each patient received over their course. Patient characteristics, differences between those with sport and non-sport etiologies, and correlations between the tests were also analyzed. RESULTS: Among 426 patients with concussion, SCAT3 total symptom score and symptom severity score at the initial visit predicted each of the clinical outcome variables. K-D score at the initial visit predicted the total number of visits and the total number of referrals. Those with sports-related concussions were younger, had less severely-affected test scores, had fewer visits and types of referrals, and were more likely to have clinical resolution of their concussion and to reach a symptom severity score≤7. CONCLUSIONS: This large-scale study of concussion patients supports the use of sideline concussion tests as part of outpatient concussion assessment, especially the total symptom and symptom severity score portions of the SCAT3 and the K-D. Women in this cohort had higher total symptom and symptom severity scores compared to men. Our data also suggest that those with non-sports-related concussions have longer lasting symptoms than those with sports-related concussions, and that these two groups should perhaps be regarded separately when assessing outcomes and needs in a multidisciplinary setting.
OBJECTIVE: This study investigated the utility of sideline concussion tests, including components of the Sports Concussion Assessment Tool, 3rd Edition (SCAT3) and the King-Devick (K-D), a vision-based test of rapid number naming, in an outpatient, multidisciplinary concussion center treating patients with both sports-related and non-sports related concussions. The ability of these tests to predict clinical outcomes based on the scores at the initial visit was evaluated. METHODS: Scores for components of the SCAT3 and the K-D were fit into regression models accounting for age, gender, and sport/non-sport etiology in order to predict clinical outcome measures including total number of visits to the concussion center, whether the patient reached a SCAT3 symptom severity score≤7, and the total types of referrals each patient received over their course. Patient characteristics, differences between those with sport and non-sport etiologies, and correlations between the tests were also analyzed. RESULTS: Among 426 patients with concussion, SCAT3 total symptom score and symptom severity score at the initial visit predicted each of the clinical outcome variables. K-D score at the initial visit predicted the total number of visits and the total number of referrals. Those with sports-related concussions were younger, had less severely-affected test scores, had fewer visits and types of referrals, and were more likely to have clinical resolution of their concussion and to reach a symptom severity score≤7. CONCLUSIONS: This large-scale study of concussion patients supports the use of sideline concussion tests as part of outpatient concussion assessment, especially the total symptom and symptom severity score portions of the SCAT3 and the K-D. Women in this cohort had higher total symptom and symptom severity scores compared to men. Our data also suggest that those with non-sports-related concussions have longer lasting symptoms than those with sports-related concussions, and that these two groups should perhaps be regarded separately when assessing outcomes and needs in a multidisciplinary setting.
Authors: Justine B Lawrence; Mohammad N Haider; John J Leddy; Andrea Hinds; Jeffery C Miecznikowski; Barry S Willer Journal: J Neurol Sci Date: 2018-12-22 Impact factor: 3.181
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Authors: Doria M Gold; John-Ross Rizzo; Yuen Shan Christine Lee; Amanda Childs; Todd E Hudson; John Martone; Yuka K Matsuzawa; Felicia Fraser; Joseph H Ricker; Weiwei Dai; Ivan Selesnick; Laura J Balcer; Steven L Galetta; Janet C Rucker Journal: Brain Sci Date: 2021-11-27