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Second Round Abstract Submissions
7) Recovery
7.26 Optimizing concussion care seeking (OCCS): the influence of continued participation on concussion recovery
  1. Julianne D Schmidt1,
  2. Zachary Yukio Kerr2,
  3. Daniel Leeds3,
  4. Robert C Lynall1,
  5. Christopher D’Lauro4,
  6. Johna Register Mihalik5,
  7. Emily Kroshus6,
  8. Michael A McCrea8,
  9. Thomas McAllister9,
  10. Steven P Broglio10
  1. 1UGA Concussion Research Laboratory, University of Georgia, Athens, USA
  2. 2Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, USA
  3. 3Computer and Information Sciences, Fordham University, New York, USA
  4. 4Department of Behavioral Sciences and Leadership, USA Air Force Academy, Colorado Springs, USA
  5. 5Matthew Gfeller Sport-Related TBI Research Center and STAR Heel Performance Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC., Chapel Hill, USA
  6. 6University of Washington, Department of Pediatrics and Seattle Children’s Research Institute, Center for Child, Development and Health, Seattle, WA, Seattle, USA
  8. 8Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, USA
  9. 9Department of Psychiatry, Indiana University School of Medicine, Indianapolis, USA
  10. 10University of Michigan Concussion Center, University of Michigan, Ann Arbor, USA

Abstract

Objective Approximately 51–64% of athletes and military service academy cadets delay seeking care following concussion. Delayed care-seeking is associated with longer recovery. We aimed to determine whether longer duration of continued participation after concussion was associated with recovery duration.

Design Longitudinal cohort.

Setting Clinical.

Participants 717 CARE Consortium concussion cases from collegiate athletes and military cadets.

Outcome Measures Recovery Duration was defined: first, as the number of days between injury and asymptomatic evaluation date, and second, as the number of days from injury to unrestricted return to activity. We used two multivariable linear regression models with duration of continued participation after injury (minutes – clinician reported) predicting days to asymptomatic and return to activity, while controlling for site, sex, race, ethnicity, sport contact level, and concussion history.

Main Results The 717 athletes and cadets that continued to participate did so for an average 33.9±35.7 minutes after incident injury. We observed a positive association between the duration of time until removal from activity and the number of days until becoming asymptomatic (P=0.04). For every additional 30-minute delay until removal from play, the number of days until becoming asymptomatic increased 8.1% (95%CI: 0.3–16.4%). There was no association with days until return to activity (p=0.11).

Conclusions When applied to a 15-day recovery, a two-hour delay in removal may extend time to asymptomatic by 5 days, resulting in a 20-day recovery. Continued participation after injury was associated with longer symptom recovery, which should be a clinical consideration when managing concussion.

https://doi.org/10.1136/bjsports-2023-concussion.319

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