@article{ref1,
title="Specific factors influence postconcussion symptom duration among youth referred to a sports concussion clinic",
journal="Journal of pediatrics",
year="2016",
author="Heyer, Geoffrey L. and Schaffer, Caroline E. and Rose, Sean Carroll and Young, Julie A. and McNally, Kelly A. and Fischer, Anastasia N.",
volume="174",
number="",
pages="33-38.e2",
abstract="OBJECTIVE: To identify the clinical factors that influence the duration of postconcussion symptoms among youth referred to a sports concussion clinic. STUDY DESIGN: A retrospective cohort study was conducted to evaluate several potential predictors of symptom duration via a Cox proportional hazards analyses. The individual postconcussion symptom scores were highly correlated, so these symptoms were analyzed in the statistical model as coefficients derived from principal component analyses. <br><br>RESULTS: Among 1953 youth with concussion, 1755 (89.9%) had dates of reported symptom resolution. The remainder (10.1%) were lost to follow-up and censored. The median time to recovery was 18 days (range 1-353 days). By 30 days, 72.6% had recovered; by 60 days, 91.4% had recovered; and by 90 days, 96.8% had recovered. Several variables in a multivariate Cox model predicted postconcussion symptom duration: female sex (P < .001, hazard ratio [HR] = 1.28), continued activity participation (P = .02, HR = 1.13), loss of consciousness (P = .03, HR = 1.18), anterograde amnesia (P = .04, HR = 1.15), premorbid headaches (P = .03, HR = 1.15), symptom components from the day of concussion (emotion, P = .03, HR = 1.08), and the day of clinic evaluation (cognitive-fatigue, P < .001, HR = 1.22; cephalalgic, P < .001, HR = 1.27; emotional, P = .05, HR = 1.08; arousal-stimulation, P = .003, HR = 1.1). In univariate analyses, greater symptom scores generally predicted longer symptom durations. Worsening of symptoms from the day of concussion to the day of clinic evaluation also predicted longer recovery (P < .001, HR = 1.59). <br><br>CONCLUSIONS: Several factors help to predict protracted postconcussion symptom durations among youth referred to a sports concussion clinic.<br><br>Copyright © 2016 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0022-3476",
doi="10.1016/j.jpeds.2016.03.014",
url="http://dx.doi.org/10.1016/j.jpeds.2016.03.014"
}