title: Symptom severity predicts prolonged recovery after sport-related concussion, but age and amnesia do not.
abstract: OBJECTIVE
  To identify predictors of prolonged symptoms in athletes who sustain concussions.
  
  
  METHODS
  This was a multicenter prospective cohort study of patients in 2 sport concussion clinics. Possible predictors of prolonged symptoms from concussion were compared in 2 groups, those whose symptoms resolved within 28 days and those whose symptoms persisted beyond 28 days. Candidate predictor variables were entered into a logistic regression model that was used to generate aORs.
  
  
  RESULTS
  A total of 182 patients met the inclusion criteria during the study period. The mean patient age was 15.2 ± 3.04 years. More than one-third of the patients (n = 65) underwent computerized neurocognitive testing on their initial visit. On univariate analyses, Post-Concussion Symptom Scale (PCSS) score and all composite scores on computerized neurocognitive testing were apparently associated with prolonged symptom duration. Sex, age, loss of consciousness at time of injury, and amnesia at time of injury were not associated with prolonged symptom duration. After adjusting for potential confounding, only total PCSS score was associated with the odds of suffering prolonged symptoms.
  
  
  CONCLUSIONS
  Further efforts to develop clinical tools for predicting which athletes will suffer prolonged recoveries after concussion should focus on initial symptom score.
authors.affiliation: Micheli Center for Sports Injury Prevention, Sports Concussion Clinic, Division of Sports Medicine, Children’s Hospital Boston, Boston, MA 02115, USA. william.meehan@childrens.harvard.edu
authors.forename: William P
authors.initials: WP
authors.lastname: Meehan
authors.forename: Rebekah C
authors.initials: RC
authors.lastname: Mannix
authors.forename: Andrea
authors.initials: A
authors.lastname: Stracciolini
authors.forename: R J
authors.initials: RJ
authors.lastname: Elbin
authors.forename: Michael W
authors.initials: MW
authors.lastname: Collins
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000647:Amnesia / Q000209:etiology; D001265:Athletic Injuries / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D001924:Brain Concussion / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D003661:Decision Support Techniques; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
keywords: ImPACT; Immediate postconcussion assessment and cognitive testing; PCSS; Post-Concussion Symptom Scale