Is The Ability To Estimate Subjective Recovery From Sports-related Concussion Associated With Recovery Time?

Is the Ability to Estimate Subjective Recovery from Sports-Related Concussion Associated with Recovery Time?Fischer, Anastasia1,2; Ding, Kele3; Yang, Jingzhen2,41. Nationwide Children’s Hospital, Columbus, OH2. The Ohio State University College of Medicine, Columbus, OH 3. Kent State University, Kent, OH4. Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH PURPOSE: To determine if difficulty assessing subjective improvement over time was associated with prolonged recovery from sports-related concussion. METHODSWe retrospectively analyzed electronic health record data of patients (10-18 years) collected by one physician at sports medicine concussion clinics affiliated with Nationwide Children’s Hospital between 1/2019 and 11/2023. Differences between subjective percent improvement since injury (PI) and change in postconcussion symptom score (SI) over time were examined to determine risk for recovery >28 days using generalized linear mixed models. Patients were classified as correct estimators (PI within 10% of SI), over-estimators (PI>SI greater than 10%) or under-estimators of recovery (P < SI greater than 10%) as well as classified as moderately poor estimators (PI 10-30% different than SI) or very poor estimators (PI >30% different than SI). RESULTS: 151 concussions sustained by 145 patients were studied. Patient demographics included sex (56% male, 44% female), ethnicity (63% white, 26% black, 11% other), age (15% <10-13yo, 85% 14-18yo), sport played (20% football, 15% basketball, 12% soccer, <5% other), and history of prior concussion (68% none). Patients who were either over or under-estimators were more likely to experience postconcussion symptoms 28 days or more (p = 0.05). Patients who were moderately poor or very poor estimators were also more likely to experience postconcussion symptoms 28 days or more (p < 0.05). CONCLUSION: Patients who have difficulty assessing their subjective improvement from sports related concussion over time are more likely to experience symptoms for longer than 28 days.