To determine the most common cause of concussion seen at NYU, to determine if test scores showed a correlation, and to see if scores were affected by cause of concussion.  

According to the CDC, TBI-related injuries contributed to approximately 2.5 million emergency department visits, hospitalizations, and deaths in the United States. Although TBIs are most notably associated with sports, many causes are actually from motor vehicle crashes, suicide attempts, and falls. Currently the SCAT-3 (Sport Concussion Assessment Tool) is used to assess sports-related concussions on the sideline. However, not a lot is known about the validity of SCAT-3 in the diagnosis of non-sports concussions.

We performed a cross-sectional observational study and administered the SCAT-3 to 754 patients (6-86 years-old) with a concussion who received care at NYU. The tests within the SCAT-3 include the SAC (Standardized Assessment of Concussion), mBESS (Modified Balance Error Scoring System), and the TTG (Timed Tandem Gait). Patient age, accident etiology, MULES test performance, and consequences from TBI were evaluated in relation to SCAT-3 outcome measures.  

Participants sustained concussions due to sports (24.9%), falls (26.7%), motor vehicle accidents (20.0%), and trauma (31.6%).

Trauma and assault were associated with a lower SAC total score when controlling for age. Fall, trauma, motor vehicle accidents, and helmeted sports demonstrated higher BESS scores. Only falls show association with longer tandem gait times.

Higher symptom severity scores were associated with more total symptoms, longer MULES time, lower SAC total scores, higher mBESS scores, and longer TTG times. Longer MULES times and errors were associated with lower (worse) SAC total scores, higher (worse) mBESS scores, and longer (worse) TTG times.

This study demonstrated that falls and trauma-related concussions are more commonly seen at NYU than sports related concussions, and the relations between the MULES test and parts of the SCAT-3.