A - 51 Delayed Presentation After a Sports-Related Concussion and Clinical Metrics

Abstract Purpose To identify factors that impact presentation timeline to a healthcare provider after a sports-related concussion (SRC). Method A retrospective study analyzed 447 athletes aged 12–23 who presented to a regional sports concussion center. Patient information and injury details were extracted from medical records. Clinical presentation was dichotomized as immediate (i.e., 1) athlete withheld from play after on-field evaluation by provider at time of injury or 2) athlete presented to a clinical setting immediately after practice/game) vs. delayed (i.e., those who failed to present immediately to a provider after the injury/competition or those who did not seek care from a physician until the next day). Clinical symptoms and recovery were compared between the groups. Results While sex, race, sport, school type, and competition type did not significantly influence immediate (n = 200) vs. delayed (n = 166) presentations, on-field evaluation predicted immediate presentation (B: 0.008, p = 0.001). Even with an on-field evaluation, some patients (n = 34) had delayed care, most commonly due to non-immediate disclosure of symptoms to the on-field provider (44.1%). Delayed athletes had a significantly higher initial post-concussion symptom scores (median = 24.0, IQR = 11.0–40.3) than those without (median = 17.0, IQR = 5.0–36.5; H = 6.982, p = 0.008). Post-hoc analysis of a data subset revealed no significant differences in time to return-to-learn, symptom resolution, or return-to-play. Conclusions On-field evaluations by a healthcare provider are critical for timely care after SRCs, and delayed care often resulted from the athlete’s hesitance to report injuries immediately. Therefore, it is important to prioritize increasing provider presence at sporting events, such as more ATCs, and educating athletes to promptly report injuries.