Comparison of Preinjury and Clinical Characteristics Between Adolescents With Sport-Related Concussion and Nonsport-Related Concussion Presenting to a Specialty Concussion Clinic.

Abstract

The aim of the study was to compare preinjury and initial subacute clinical characteristics of adolescents with sport-related concussion to those with nonsport-related concussion who present to a specialty concussion clinic. This is a cross-sectional analysis of 136 adolescents 10-18 (mean = 14.4 ± SD = 2.3) yrs presenting to a specialty concussion clinic 2-30 (M = 9.25 ± SD = 6.3) days after injury. Main measures included 1) clinical interview, 2) Immediate Post-Concussion Assessment and Cognitive Test, 3) Post-Concussion Symptom Scale, 4) Vestibular/Ocular-Motor Screening, 5) Screen for Child Related Anxiety Disorders-Child Version, and 6) Generalized Anxiety Disorder Assessment. One hundred one (74.3%) participants reported a sport-related concussion, and 35 (25.7%) reported a nonsport-related concussion. Adolescents presenting to the clinic with nonsport-related concussion were older, more likely to be female, presented to the clinic later, and reported headache/migraine and depression history ( P  < 0.05). These adolescents also reported a higher PCSS symptom severity and GAD-7 total score compared to their sport-related concussion counterparts ( P  < 0.01). Forward stepwise logistic regression revealed significant associations between nonsport-related concussion and headache/migraine history (adjusted adjusted odds ratio = 2.95, 95% confidence interval = 1.17-7.47, P  = 0.022), Post-Concussion Symptom Scale total score (adjusted odds ratio = 1.04, confidence interval = 1.02-1.06, P  < 0.001), and days to clinic (odds ratio = 1.08, 95% confidence interval = 1.01-1.15, P  = 0.029). The most salient factors associated with nonsport-related concussion patients presenting to a specialty concussion clinic were a headache/migraine history, a longer time to clinic, and greater initial visit symptoms. These findings suggest that the factors that lead patients with sport-related concussion and nonsport-related concussion to present to a specialty clinic differ, and that studies that are interested in differences in clinical characteristics based on mechanism of injury will need to address substantial referral differences between these two populations that would confound such findings.