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Abstract Details

Male and Female Differences in Concussion Recovery: The Influence of Time to Clinic Presentation
Neuro Trauma and Critical Care
P10 - Poster Session 10 (5:00 PM-6:00 PM)
4-001
The aim of this study was to investigate the relationship between sex, time to clinic presentation, and recovery time
Recovery time following concussion has previously been demonstrated to vary by sex.  Time to clinic presentation may influence timing of treatment initiation and thereby affect concussion recovery outcomes. 
Secondary analysis of existing clinical data between 2017 and 2019.  Patients ages 6-24 years diagnosed with concussion were eligible for inclusion if their initial clinic visit occurred within 3 weeks from the date of injury. Unadjusted Kaplan Meier survival curves were used to display time to clinic presentation and time to recovery by sex.  To test the association between time to recovery and sex, we conducted three separate cox proportional hazard regressions to estimate hazard ratios (HR) with 1) sex as the primary exposure, 2) sex while adjusting for age, concussion history, symptom severity, and distance from the clinic, 3) sex while adjusting for days to clinic presentation, age, concussion history, symptom severity, and distance from the clinic.
A total of 486 patients (15.5 ± 3.1 years; 285 males, 58.6%) presenting to the clinic within 20 days. Unadjusted cox regression revealed females had slower recovery (HR: 0.70, 95%CI: 0.56,0.86) than males. When adjusting for age, concussion history, symptom severity, and clinic distance females had slower recovery than males (aHR 0.80, 95% CI: 0.64,1.00). When adding days to first clinic visit as a covariate sex differences were null (aHR: 0.91, 95% CI: 0.73, 1.13).  

Males and females treated at a specialty concussion clinic displayed overall differences in recovery outcomes, aligning with prior research suggesting females exhibit slower recovery outcomes. However, when adjusting for notable covariates, specifically time to clinic presentation, there were no significant sex differences. These findings suggest a potential sex-based disparity in post-concussion healthcare activation and highlight opportunities to improve concussion outcomes. 
Authors/Disclosures
Brandon S. Wright
PRESENTER 		Mr. Wright has nothing to disclose.
Matthew T. Lorincz, MD, PhD (University of Michigan-NCAC Neurology) Dr. Lorincz has received personal compensation for serving as an employee of Alexion. Dr. Lorincz has received personal compensation for serving as an employee of Orphalon . Dr. Lorincz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Lorincz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Orphalon . Dr. Lorincz has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Medlink Neurology. The institution of Dr. Lorincz has received research support from Alexion.
Douglas Weibe (University of Michigan Injury Prevention Center) No disclosure on file
Andrea Almeida, MD (University of Michigan Department of Neurology) Dr. Almeida has nothing to disclose.
Jere Freeman (University of Michigan) No disclosure on file
jason goldstick, PhD Dr. goldstick has nothing to disclose.
Michael Popovich, MD (NCAC) Dr. Popovich has nothing to disclose.
Ingrid Ichesco (Michigan Medicine) Ingrid Ichesco has nothing to disclose.
James T. Eckner, MD (University of Michigan Dept of PM&R) An immediate family member of Dr. Eckner has received personal compensation for serving as an employee of Autism Alliance of Michigan. The institution of Dr. Eckner has received research support from NIH. The institution of Dr. Eckner has received research support from Department of Defense. Dr. Eckner has received intellectual property interests from a discovery or technology relating to health care. Dr. Eckner has received personal compensation in the range of $500-$4,999 for serving as a CARE Consortium Publication Committee Member with Indiana University. Dr. Eckner has received personal compensation in the range of $0-$499 for serving as a 好色先生al Content Contributor with Move United.
Abigail Bretzin, PhD The institution of Dr. Bretzin has received research support from Ivy League Big Ten University Presidents.