title: Initial somatic symptoms are associated with prolonged symptom duration following concussion in adolescents.
abstract: OBJECTIVE
  To determine which initial postinjury symptom domains are independently associated with symptoms lasting >28 days in youth athletes who sustained sport-related concussions.
  
  
  METHODS
  Patients who presented for care at a sport concussion clinic completed the postconcussion symptom scale. They were classified into two groups: those who reported symptom resolution within 28 days of injury and those who did not. Logistic regression models were constructed for children and adolescents to determine the independent association between symptom recovery and potential predictor variables: initial symptom scores in 5 postconcussion symptom scale domains (somatic, vestibular-ocular, cognitive, sleep and emotional), sex, loss of consciousness or amnesia at the time of injury, history of prior concussion, prior treatment for headaches or migraines, or family history of concussion.
  
  
  RESULTS
  Sixty-eight child (8-12 years of age) and 250 adolescent (13-18 years of age) athletes were included. For adolescents, initial somatic symptom severity was independently associated with prolonged symptom duration (adjusted odds ratio = 1.162; 95% CI: 1.060, 1.275) and no other predictor variables were. No potential predictor variables were independently associated with prolonged symptom duration for children.
  
  
  CONCLUSIONS
  Among adolescent athletes, a high initial somatic symptom burden (e.g. headache, nausea, vomiting, etc.) is associated with increased odds of symptoms beyond 28 days postinjury.
authors.affiliation: The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.|Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA, USA.|Brain Injury Center, Boston Children's Hospital, Boston, MA, USA.
authors.forename: David R
authors.identifier: http://orcid.org/0000-0002-2955-0191
authors.initials: DR
authors.lastname: Howell
authors.affiliation: The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.|Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA, USA.|Brain Injury Center, Boston Children's Hospital, Boston, MA, USA.|Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: O'Brien
authors.affiliation: Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA, USA.|Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Beasley
authors.affiliation: Brain Injury Center, Boston Children's Hospital, Boston, MA, USA.|Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA.|Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
authors.forename: Rebekah C
authors.initials: RC
authors.lastname: Mannix
authors.affiliation: The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.|Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA, USA.|Brain Injury Center, Boston Children's Hospital, Boston, MA, USA.|Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA.|Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA.|Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
authors.forename: William P
authors.initials: WP
authors.lastname: Meehan
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries; D001924:Brain Concussion; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D000071896:Medically Unexplained Symptoms
keywords: Brain injury; Sports; Symptom questionnaire; Symptoms and traumatic brain injury