@article{ref1,
title="Medical disqualification following concussion in collegiate student-athletes: findings from the CARE consortium",
journal="Sports medicine",
year="2020",
author="Schmidt, Julianne D. and Rawlins, Michelle L. Weber and Lynall, Robert C. and D'Lauro, Christopher and Clugston, James R. and McAllister, Tom W. and McCrea, Michael and Broglio, Steven P.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: The absence of evidence-based guidelines make medical disqualification (MDQ) following concussion one of the most challenging decision-making processes faced by sports medicine professionals. <br><br>OBJECTIVE: We aimed to compare premorbid and postmorbid factors between student-athletes that were and were not medically disqualified from sport following a concussion. <br><br>METHODS: Among 1832 student-athletes diagnosed with concussion within the CARE Consortium, 53 (2.9%) were medically disqualified (MDQ +) and 1779 (97.1%) were not medically disqualified (MDQ-). We used contingency tables and descriptive statistics for an initial evaluation of a broad list of premorbid and postmorbid factors. For those factors showing association with MDQ status, we calculated odds ratios and 95% confidence intervals for the odds of being MDQ + in the presence of the identified factor. <br><br>RESULTS: History of 2 (OR: 3.2, 95% CI 1.5, 6.9) or 3 + (OR: 7.4, 95% CI 3.4, 15.9) previous concussions; 1 + headaches in past 3 months (OR: 1.8, 95% CI 1.0, 3.2); immediate removal from play (OR: 2.4, 95% CI 1.2, 4.9); alcohol (OR: 2.6, 95% CI 1.2, 5.4), tobacco (OR: 3.3, 95% CI 1.1, 9.5), or marijuana use since injury (OR: 5.4, 95% CI 1.5, 19.0); as well as prolonged recovery due to mental health alterations (OR: 5.3, 95% CI 2.0, 14.1) or motivation/malingering (OR: 7.5, 95% CI 3.3, 17.0) increased odds of being MDQ + . The MDQ + group took longer to become asymptomatic relative to the MDQ- group (MDQ + : 23.5 days, 95% CI 15.8, 31.2; MDQ-: 10.6 days, 95% CI 9.5, 11.6; p < 0.001). <br><br>CONCLUSIONS: MDQ following concussion was relatively rare. We identified three patterns related to MDQ following concussion: (1) concussion and headache history were the only premorbid factors that differed (2) initial concussion presentation was more severe and more immediate in the MDQ + group, and (3) post-concussion recovery outcomes expressed the greatest differences between groups.<p /> <p>Language: en</p>",
language="en",
issn="0112-1642",
doi="10.1007/s40279-020-01302-y",
url="http://dx.doi.org/10.1007/s40279-020-01302-y"
}