Abstract Details

Title Use of a Novel Clinically Relevant Symptom Scale for Acute Concussion

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-051

Objective

To compare a novel, clinically relevant symptom scale to a validated scale for acute concussion.

Background

Concussion is diagnosed clinically using a comprehensive history and exam, supported by ancillary testing. Frequently, symptom checklists are used as part of the evaluation of concussion. Existing symptom scales are based on a subjective Likert scale, without relation of symptoms to clinical impairment.

Design/Methods Retrospective review of 133 patients under age 30 seen in an outpatient neurology practice within 30 days of a probable or definite concussion. Each patient completed 2 symptom checklists – the SCAT-3 symptom evaluation (22 symptoms, 0-6 scale) and a novel clinically relevant symptom checklist (30 symptoms, 0-3 scale related to functional impact of the symptom). Final clearance date was determined by the treating physician.

Results 60.9% of patients were male with mean age 15.7 years (SD 2.3). Mean time from concussion to first visit was 6.9 days (SD 6.2), and 101 patients had definite concussions (75.9%), while 32 were diagnosed as probable (24.1%). 94 patients had a known clearance date (70.7%) with mean clearance time of 20.6 days (SD 18.6) and median clearance time of 19 days (95% CI 16-21). Mean total symptom score was 27.2 (SD 22.9) on the SCAT-3 and 15.1 (SD 12.5) for the novel scale. Pearson’s correlation between the two scales was 0.797 (p<0.001). After adjusting for patient and injury characteristics, higher total scores for each scale were associated with longer recovery times (SCAT-3 HR 0.976, 95%CI 0.965-0.988, p<0.001; novel scale HR 0.943, 95%CI 0.922-0.964, p<0.001).

Conclusions

A novel, clinically relevant concussion symptom scale correlates strongly with the SCAT-3 scale and demonstrates a similar association with time to clearance. By assessing the degree of impact on clinical functioning, this novel symptom scale reflects a more intuitive approach to rating symptoms and can be used in the management of concussion.

Authors/Disclosures
Matthew T. McCarthy, MD PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Anthony K. Savino, MD (Illinois Bone and Joint Sports Neurology)	No disclosure on file
Jeffrey S. Kutcher, MD, FAAN (Kutcher Clinic for Sports Neurology)	Dr. Kutcher has nothing to disclose.
	No disclosure on file
Sean C. Rose, MD, FAAN (Nationwide Children's Hospital)	Dr. Rose has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Summit Experts. The institution of Dr. Rose has received research support from Dale Earnhardt Jr Foundation.

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