Abstract Details

Title Over-the-counter Analgesic Use After Concussion: Findings from the Concussion Assessment, Research, and ��ɫ�� (CARE) Consortium

Topic Neuro Trauma and Critical Care

Presentation(s) S26 - Neuro Trauma and Sports Neurology (1:00 PM-1:12 PM)

Poster/Presentation
Number 001

Objective To determine if postinjury over-the-counter (OTC) analgesic use, along with type and timing of medications is associated with concussion recovery and symptom severity in National Collegiate Athletic Association (NCAA) athletes and military cadets.

Background OTC analgesics have been shown to reduce neuroinflammation after traumatic brain injury (TBI). However, there is little evidence-based research evaluating the effect of OTC analgesics on clinical outcomes after concussion.

Design/Methods This prospective cohort study was conducted by the NCAA and US Department of Defense CARE Consortium. Participant groups were categorized as those who did and did not use OTC analgesics postinjury. OTC analgesic type was categorized as acetaminophen (n=660) vs non-steroidal ani-inflammatory drugs (NSAIDs) (n=75) vs both (n=78). Concussion recovery was measured as days from injury to clearance to return to unrestricted play (URTP) and to return to asymptomatic (daysASYMP). Symptom and headache severity were derived from the Sports Concussion Assessment Tool (SCAT-3) and taken at baseline (preseason), immediately postinjury (< 1-day postinjury), and postinjury (median of 3 days postinjury).

Results There were 813 who did and 848 who did not use OTC analgesics included in the study. OTC analgesic use was associated with faster URTP, sooner daysASYMP (HR 0.796, 95% CI 0.697 to 0.909, p <0.001and HR 0.851, 95% CI 0.744-0.972, p=0.034 respectively) and lower postinjury symptom and headache severity scores (logarithmic transformed Estimated Mean difference -0.957 95% CI -0.944 to -0.959, p<0.001 and -1.07 95% CI -1.06 to -1.08, p<0.001 respectively). Earlier OTC analgesic use after injury was associated with quicker URTP and daysASYMP (p<0.001). There were no significant differences among OTC analgesic type and concussion recovery or symptom severity.

Conclusions OTC analgesics were associated with improved concussion symptoms and recovery. This was not dependent on medication type. Early medication use was associated with shorter recovery times. These findings can enhance our knowledge of treatments for concussion.

Authors/Disclosures
Kyle Arnold, MD PRESENTER	Dr. Arnold has nothing to disclose.
Yeo Won Kim, MD	Dr. Kim has nothing to disclose.
Steven Broglio, PhD (NeuroTrauma Research Laboratory)	Dr. Broglio has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for MCW. Dr. Broglio has received personal compensation in the range of $0-$499 for serving as a Consultant for U Calgary. Dr. Broglio has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Montgomery McCracken Walker & Rhoads LLP. The institution of Dr. Broglio has received research support from DoD. The institution of Dr. Broglio has received research support from NCAA.
Thomas W. McAllister, MD (Indiana University School of Medicine)	The institution of Dr. McAllister has received research support from U.S. Department of Defense. The institution of Dr. McAllister has received research support from NCAA. The institution of Dr. McAllister has received research support from National Institute of Health. Dr. McAllister has received publishing royalties from a publication relating to health care.
Michael McCrea, PhD, ABPP (Medical College of Wisconsin)	Dr. McCrea has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurotrauma Sciences. The institution of Dr. McCrea has received research support from NIH. The institution of Dr. McCrea has received research support from DoD. The institution of Dr. McCrea has received research support from NCAA. The institution of Dr. McCrea has received research support from NFL. The institution of Dr. McCrea has received research support from CDC. The institution of Dr. McCrea has received research support from Abbott Labs. Dr. McCrea has received publishing royalties from a publication relating to health care.
Tara Sharma, DO (UCLA)	Dr. Sharma has stock in JP Morgan . Dr. Sharma has stock in Profunds.

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