A - 36 Exploring Impact of Sex, Age, and Symptom Burden on Persisting Symptoms in Pediatric Sport-Related Concussion

Abstract Purpose This study explored the role of biological sex, age, and symptom burden to determine associated risk for persisting symptoms following a pediatric sport-related concussion (SRC). Method This retrospective cohort study included 1554 child (n = 290) and adolescent (n = 1264) athletes evaluated at a pediatric sports medicine clinic following SRC. Inclusion criteria were initial clinic visit within 7 days post-SRC, completion of the Post-Concussion Symptom Scale (PCSS, a measure of concussion-related symptoms) at initial visit, and recovery duration from injury to asymptomatic clinic encounter within 2 standard deviations of the sample mean. Primary independent variables included biological sex, age (5–12 vs. 13–18), and symptom burden (total reported number of PCSS symptoms at initial clinic visit). Analyses explored interactions among these variables to determine associated risk for persisting symptoms after concussion (PSaC; recovery duration >28 days). Results Binary logistical regression revealed symptom burden at initial clinic visit significantly predicted PSaC (OR = 1.286, 95% CI = 1.134–1.459, p < 0.001). Females (n = 609) across age groups demonstrated a stronger relationship between symptom burden and PSaC compared with males (OR = 0.910, 95% CI = 0.839–0.988, p = 0.024). Age was not a significant predictor of recovery outcomes. Conclusions Symptom burden was the strongest predictor of PSaC, with females across age groups demonstrating greater vulnerability to initial symptom burden than males. Findings are consistent with current literature suggesting greater symptom burden and prolonged recovery in adolescent female athletes. This study extends these observations to female child athletes, highlighting a similar pattern in a younger, understudied population.