Objective This study examined factors predictive of post-concussion syndrome (PCS; i.e., concussion-related symptoms lasting ≥4 weeks) among high school (HS) student-athletes during the 2011/12-2013/14 academic years.

Design Prospective cohort.

Setting Concussion data originated from the National Athletic Trainers Injury and Outcomes Network (NATION), a nationwide surveillance program comprised of a convenience sample of 127 HS. All concussions were diagnosed and reported by athletic trainers and team physicians.

Subjects Our sample included 1846 concussed HS student-athletes from 22 sports (73.7% male). For student-athletes with multiple concussions, only the most recent concussion was considered.

Intervention Factors potentially related to PCS (i.e., sex, sport contact level, recurrent concussion, presence of symptoms) were examined.

Outcome measures The 215 concussed student-athletes with PCS were compared to 1119 concussed student-athletes with symptoms lasting <2 weeks. Those with symptoms lasting 2-4 weeks were excluded (n=512). Logistic regression predicted the odds of PCS.

Results In multivariate analysis, concussion symptoms associated with increased odds of PCS were somatic symptoms including: disorientation [odds ratio (OR)=1.86, 95% confidence interval (CI):1.04–3.33]; balance issues (OR=1.76, 95% CI: 1.00–3.10); visual impairments (OR=2.21, 95% CI: 1.23–3.97); noise sensitivity (OR=1.80, 95% CI: 1.02–3.17); and cognitive symptoms including: retrograde amnesia (OR=3.01, 95% CI: 1.31–6.91); and difficulty concentrating (OR=2.72, 95% CI:1.56–4.77). Sex, sport contact level, and recurrent concussion were not associated with PCS.

Conclusions As in previous research, various somatic and cognitive symptoms were associated with PCS. The identification of risk factors potentially associated with PCS may assist clinicians in providing timely interventions to shorten symptom resolution and recovery time.

Competing interests None