Impact Of Prior Concussion History On Baseline Concussion Symptom Clusters In Adolescent Football Athletes

It is estimated that approximately 400,000 sport related concussions occur in high school-aged adolescents annually. While the majority will recover within four weeks, approximately 30% will experience persistent post-concussive syndrome lasting more than the expected recovery timeframe. To date no study addressing prolonged post-concussive symptom clusters has been done in high school athletes or using the Post-Concussion Symptom Scale (PCSS). Purpose: Examine differences in baseline symptom reporting based on clustering of post-concussive symptoms in adolescent football athletes, with and without a history of concussion. Methods: A retrospective cohort design was used to analyze adolescent (15.66±1.21 years) football athletes’ baseline concussion symptom presentation. History of concussion was self-reported (Have you ever been diagnosed with a concussion? [yes/no] or ‘Do you think you have had a concussion that has gone undiagnosed by a medical professional? [yes/no]). Symptom evaluation consisted of the 22-item PCSS, with individual symptoms rated from 0 (none) to 6 (severe). Outcome measures consisted of the symptom severity score of each symptom cluster: cognitive (out of 24), physical (out of 48), affective (out of 24) and sleep (out of 30). Differences within clusters was evaluated between those with a history of concussion and those without, using Mann-Whitney U tests. Statistical significance was set a priori p<0.05. Results: Mean scores of symptom clusters is shown in Table 1. Those with a history of concussion reported significantly greater severity of physical (p=0.006) and sleep (p=0.002) symptoms. Conclusion: Adolescent football athletes with a history of concussion reported significantly greater severity on two of the four symptom clusters. This study adds to the literature surrounding patient symptom profiles and has the potential to improve post-concussion assessment and care. - Symptom Cluster History of Concussion (n=48) No History of Concussion (n=201) Cognitive 2.19±3.70 1.28±2.58 Physical* 4.23±6.05 2.46±4.83 Affective 3.02±4.91 1.64±3.01 Sleep* 4.58±4.95 2.41±3.72