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Optimizing Concussion Care Seeking: A Longitudinal Analysis of Recovery.
Schmidt, Julianne D; Broglio, Steven P; Knight, Kristen; Leeds, Daniel; Lynall, Robert C; D'Lauro, Christopher; Register-Mihalik, Johna; Kroshus, Emily; McCrea, Michael; McAllister, Tom W; Kerr, Zachary Y; Hoy, April; Kelly, Louise; Master, Christina; Ortega, Justus; Port, Nicholas; Campbell, Col Darren; Svoboda, Col Steven J; Putukian, Margot; Chrisman, Sara P D; Langford, Dianne; McGinty, Gerald; Jackson, Jonathan C; Cameron, Kenneth L; James Susmarski, Adam; DiFiori, John; Goldman, Joshua T; Benjamin, Holly; Buckley, Thomas; Kaminski, Thomas; Clugston, James R; O'Donnell, Patrick G; Feigenbaum, Luis; Eckner, James T; Mihalik, Jason P; Anderson, Scott; Kontos, Anthony; Brooks, M Alison; Miles, Christopher; Lintner, Laura.
Afiliación
  • Schmidt JD; UGA Concussion Research Laboratory and Department of Kinesiology, University of Georgia, Athens, Georgia, USA.
  • Broglio SP; Michigan Concussion Center and School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA.
  • Knight K; Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA.
  • Leeds D; Computer and Information Sciences, Fordham University, New York, New York, USA.
  • Lynall RC; UGA Concussion Research Laboratory and Department of Kinesiology, University of Georgia, Athens, Georgia, USA.
  • D'Lauro C; Department of Behavioral Sciences and Leadership, United States Air Force Academy, Colorado Springs, Colorado, USA.
  • Register-Mihalik J; Matthew Gfeller Research Center and STAR Heel Performance Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
  • Kroshus E; Department of Pediatrics, University of Washington, and Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA.
  • McCrea M; Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
  • McAllister TW; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.
  • Kerr ZY; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
  • Hoy A; School of Behavioral and Applied Sciences, Azusa Pacific University, Azusa, California, USA.
  • Kelly L; Department of Exercise Science, California Lutheran University, Thousand Oaks, California, USA.
  • Master C; Division of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  • Ortega J; Department of Kinesiology and Recreation Administration, Humboldt State University, Humbolt, California, USA.
  • Port N; School of Optometry, Indiana University, Bloomington, Indiana, USA.
  • Campbell CD; Intermountain Sports Medicine, Ogden, Utah, USA.
  • Svoboda CSJ; MedStar Orthopaedic Institute, Alexandria, Virginia, USA.
  • Putukian M; Athletic Medicine, Princeton University, Princeton, New Jersey, USA.
  • Chrisman SPD; Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA.
  • Langford D; Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA.
  • McGinty G; United States Air Force Academy, Air Force Academy, Colorado, USA.
  • Jackson JC; United States Air Force Academy, Air Force Academy, Colorado, USA.
  • Cameron KL; Keller Army Hospital, United States Military Academy, West Point, New York, USA.
  • James Susmarski A; Department Head Brigade Orthopaedics and Sports Medicine, United States Naval Academy, Annapolis, Maryland, USA.
  • DiFiori J; University of California, Los Angeles, Los Angeles, California, USA.
  • Goldman JT; Departments of Family Medicine and Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California, USA.
  • Benjamin H; Department of Rehabilitation Medicine and Pediatrics, University of Chicago, Chicago, Illinois, USA.
  • Buckley T; Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA.
  • Kaminski T; Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA.
  • Clugston JR; Community Health and Family Medicine, University of Florida, Gainesville, Florida, USA.
  • O'Donnell PG; UMass Memorial Health, Worcester, Massachusetts, USA.
  • Feigenbaum L; Department of Physical Therapy, Miller School of Medicine, University of Miami, Coral Gables, Florida, USA.
  • Eckner JT; Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA.
  • Mihalik JP; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
  • Anderson S; University of Oklahoma, Norman, Oklahoma, USA.
  • Kontos A; Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  • Brooks MA; Department of Orthopedics, University of Wisconsin, Madison, Wisconsin, USA.
  • Miles C; Department of Family and Community Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.
  • Lintner L; Winston-Salem State University, Winston-Salem, North Carolina, USA.
Am J Sports Med ; 51(1): 214-224, 2023 01.
Article en En | MEDLINE | ID: mdl-36412549
ABSTRACT

BACKGROUND:

Approximately half of concussions go undisclosed and therefore undiagnosed. Among diagnosed concussions, 51% to 64% receive delayed medical care. Understanding the influence of undiagnosed concussions and delayed medical care would inform medical and education practices.

PURPOSE:

To compare postconcussion longitudinal clinical outcomes among (1) individuals with no concussion history, all previous concussions diagnosed, and ≥1 previous concussion undiagnosed, as well as (2) those who have delayed versus immediate symptom onset, symptom reporting, and removal from activity after concussion. STUDY

DESIGN:

Cohort study; Level of evidence, 2.

METHODS:

Participants included 2758 military academy cadets and intercollegiate athletes diagnosed with concussion in the CARE Consortium. We determined (1) each participant's previous concussion diagnosis status self-reported at baseline (no history, all diagnosed, ≥1 undiagnosed) and (2) whether the participant had delayed or immediate symptom onset, symptom reporting, and removal from activity. We compared symptom severities, cognition, balance, and recovery duration at baseline, 24 to 48 hours, date of asymptomatic status, and date of unrestricted return to activity using tests of parallel profiles.

RESULTS:

The ≥1 undiagnosed concussion group had higher baseline symptom burdens (P < .001) than the other 2 groups and poorer baseline verbal memory performance (P = .001) than the all diagnosed group; however, they became asymptomatic and returned to activity sooner than those with no history. Cadets/athletes who delayed symptom reporting had higher symptom burdens 24 to 48 hours after injury (mean ± SE; delayed, 28.8 ± 0.8; immediate, 20.6 ± 0.7), took a median difference of 2 days longer to become asymptomatic, and took 3 days longer to return to activity than those who had immediate symptom reporting. For every 30 minutes of continued participation after injury, days to asymptomatic status increased 8.1% (95% CI, 0.3%-16.4%).

CONCLUSION:

Clinicians should expect that cadets/athletes who delay reporting concussion symptoms will have acutely higher symptom burdens and take 2 days longer to become asymptomatic. Educational messaging should emphasize the clinical benefits of seeking immediate care for concussion-like symptoms.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Traumatismos en Atletas / Conmoción Encefálica Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: Am J Sports Med Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Traumatismos en Atletas / Conmoción Encefálica Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: Am J Sports Med Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos