Abstract Details

Title Specialist Referral and Outcomes in Adolescents Athletes with Prior Concussion History

Topic Pediatric/Youth

Presentation(s) P1 - Poster Session 1 (7:00 AM-3:15 PM)

Poster/Presentation
Number 059

Objective To examine specialist referral patterns and clinical outcomes in adolescents with differing levels of prior concussion history.

Background Limited evidence exists on healthcare utilization and outcomes in concussed adolescent athletes with and without a history of prior concussion.

Design/Methods Data were prospectively collected from participants aged 12-18 diagnosed with a sport-related concussion and documented prior concussion history between August 2015-March 2020. Participants were separated into 3 groups: 0, 1, and 2+ prior concussions. Demographics, medical history, specialist referrals, and clinical outcome variables obtained at 3-months post-concussion were analyzed.

Results

1097 participants were included: 114 (10.4%) had 2+, 213 (19.4%) had 1, and 770 (70.2%) had 0 prior concussions. There was no difference in sex or time to presentation. A small difference was found across age (15.3±1.6 vs 14.9±1.6 vs 14.5±1.6 years, p<0.001). Significant differences were also observed between groups in self-reported history of psychological disorders (14.9 vs 15 vs 8.4%, p=0.01) and headaches/migraines (25.4 vs 20.2 vs 15.5%, p=0.02).

Significant differences between the groups were found in specialist referrals, with more referrals made in the 2+ group to physical therapy (39.6 vs 28.2 vs 23.4%, p=0.001), neuropsychology (17.1 vs 5.3 vs 7.5%, p=0.001), and neurology (8.9 vs 2.9 vs 2.2%, p=0.001).

Fewer participants in the 2+ group recovered in ≤30 days (53.6 vs 65.6 vs 68.5%, p=0.04) and reported lower rates of return to activity at 3-months post-concussion (67.9 vs 85.9 vs 87.6%, p < 0.001). No differences were seen in symptom severity, PHQ-8, or GAD-7 scores. All reported as 2+ vs 1 vs 0.

Conclusions Concussed adolescent athletes with a history of 2 or more prior concussions had a higher rate of specialist referrals, were less likely to have returned to prior level of play/activity 3 months following injury, and were less likely to have resolution of symptoms in 30 days or less.

Authors/Disclosures
Hannah Worrall, Other (Scottish Rite for Children) PRESENTER	Ms. Worrall has nothing to disclose.
	No disclosure on file
Munro Cullum, PhD (Univ of Texas Southwestern Medical Center)	The institution of Dr. Cullum has received research support from NIH. Dr. Cullum has received intellectual property interests from a discovery or technology relating to health care. Dr. Cullum has received personal compensation in the range of $10,000-$49,999 for serving as a Scientific Director with Texas Alzheimers Research and Care Consortium.
Shane Miller	Shane Miller has nothing to disclose.

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