Citation

Eagle SR, Kissinger-Knox AM, Feder A, Manderino L, Preszler J, Womble MN, Elbin RJ, Collins M, Kontos AP. J. Pediatr. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.jpeds.2022.02.013

PMID

35157844

Abstract

OBJECTIVE: To evaluate temporal differences in concussion symptoms up to 30 days following a sports-related concussion (SRC). STUDY DESIGN: Adolescent and young adult athletes (n=782) were separated based on time since injury at presentation as EARLY (0-7 days; n=321, age: 15.4±1.9 years, 51.7% female), MIDDLE (8-14 days; n=281, age: 15.8±2.2 years, 54.8% female) and LATE (15-30 days; n=180, age: 15.6±1.8 years, 52.8% female). All participants completed the 22-item Post-Concussion Symptom Scale at first visit. A confirmatory factor analysis (CFA) was completed separately for each time since injury cohort using a four-component model reported previously.

RESULTS: The CFA model fit was acceptable for EARLY, MIDDLE and LATE (using Cognitive/Migraine/Fatigue, Affective, Sleep and Somatic factors). Both Affective (change = 0.30; p =.01; Cohens d =.30) and Sleep (change = 0.51; p = <.001; Cohens d =.47) factors were significantly higher in the LATE group compared with the EARLY, but not MIDDLE, groups. The previously reported four-factor symptom model, including Cognitive/Migraine/Fatigue, Affective, Somatic, and Sleep factors, was appropriate for adolescents up to 30 days post-injury. However, adolescents who presented between 15-30 days post-injury reported higher Affective and Sleep symptoms than those who presented within one week.

CONCLUSIONS: Clinicians should consider these temporal differences when evaluating concussion symptoms in adolescents, as higher Affective and Sleep symptoms can be predictive of prolonged recovery/persistent complications.

Language: en