A - 11 Neuropsychological Performance of Normal and Slow-Recovering Collegiate Football Players Following Sport-Related Concussion

Abstract Purpose Sport-related concussion (SRC) is a common injury in National Collegiate Athletic Association football (NCAAF). Some student-athletes experience prolonged recoveries to unrestricted (i.e., physician cleared) return-to-play (RTP). We evaluated associations between post-injury assessment performance and odds of prolonged SRC recovery in NCAAF. Method 770 NCAAF concussed student-athletes enrolled in the NCAA-DoD CARE Consortium between 2014–2020 were analyzed. Those with missing time-to-RTP information were excluded. Our primary outcome of interest was odds of prolonged RTP. Recovery trajectories were characterized as “Normal” if time-to-RTP <28 days, and “Slow” if time-to-RTP > =28 days. Odds of experiencing slow recovery were evaluated via multivariable binomial logistic regression, accounting for injury situation (practice, game), concussion history (yes, no), post-injury Sport Concussion Assessment Tool (SCAT) symptom number, Balance Error Scoring System (BESS) total errors, and Standardized Assessment of Concussion (SAC) scores. The first assessments (<48 hours post-injury) available were analyzed. Odds ratios (OR) with accompanying 95% confidence intervals (CI) were used to evaluate associations (a = 0.05). Results 157 (20.4%) NCAAF student-athletes were grouped into Slow recovery. Per model output, each one-point increase on BESS errors was associated with 3% greater odds of slow recovery (OR: 1.03, 95% CI: 1.00–1.05), and each additional SCAT symptom reported was associated with 4% greater odds of slow recovery (OR: 1.04, 95% CI: 1.00–1.08). Conclusions The odds of slow recovery (> = 28 days) in concussed NCAAF student-athletes increased with greater post-injury symptom and balance burdens. Further research on other assessments that may provide prognostic value in NCAAF student-athletes is encouraged.