title: Academic Outcomes in High-School Students after a Concussion: A Retrospective Population-Based Analysis.
abstract: BACKGROUND
  Many concussion symptoms, such as headaches, vision problems, or difficulty remembering or concentrating may deleteriously affect school functioning. Our objective was to determine if academic performance was lower in the academic calendar year that students sustain a concussion compared to the previous year when they did not sustain a concussion.
  
  
  METHODS
  Using Manitoba Health and Manitoba Education data, we conducted a population-based, controlled before-after study from 2005-2006 to 2010-2011 academic years. Grade 9-12 students with an ICD9/10 code for concussion were matched to non-concussed controls. Overall changes in grade point average (GPA) were compared for the academic year prior to the concussion to the academic year the concussion occurred (or could have occurred among non-concussed matched students).
  
  
  RESULTS
  Overall, 8240 students (1709 concussed, 6531 non-concussed students) were included. Both concussed and non-concussed students exhibited a lower overall GPA from one year to the next. Having sustained a concussion resulted in a -0.90% (95% CI: -1.88, 0.08) reduction in GPA. Over the same period, non-concussed matched students' GPA reduced by -0.57% (95% CI: -1.32, 0.19). Students who sustained a concussion during high school were just as likely to graduate within four years as their non-concussed peers (ORadj: 0.84; 95% CI: 0.73, 1.02).
  
  
  CONCLUSIONS
  We found that, at a population level, a concussion had minimal long-term effects on academic performance during high school. While academic accommodations and Return-to-Learn programs are an important component of pediatric concussion management, research is needed to identify risk factors for poor academic performance after a concussion and who should receive these programs.
authors.affiliation: Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.|Children's Hospital Research Institute of Manitoba, Winnipeg, Canada.|Canada North Concussion Network, Winnipeg, Canada.
authors.forename: Kelly
authors.initials: K
authors.lastname: Russell
authors.affiliation: Faculty of Kinesiology and Physical Education, University of Toronto, Ontario, Canada.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Hutchison
authors.affiliation: Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.|Children's Hospital Research Institute of Manitoba, Winnipeg, Canada.
authors.forename: Erin
authors.initials: E
authors.lastname: Selci
authors.affiliation: Canada North Concussion Network, Winnipeg, Canada.|Department of Surgery, University of Manitoba, Winnipeg, Canada.
authors.forename: Jeff
authors.initials: J
authors.lastname: Leiter
authors.affiliation: Manitoba Center for Health Policy, University of Manitoba, Winnipeg, Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Chateau
authors.affiliation: Children's Hospital Research Institute of Manitoba, Winnipeg, Canada.|Canada North Concussion Network, Winnipeg, Canada.|Department of Surgery, Section of Neurosurgery, University of Manitoba, Winnipeg, Canada.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ellis
mesh_terms: D000293:Adolescent; D001924:Brain Concussion / Q000150:complications*; D065187:Controlled Before-After Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D013334:Students