Concussion Symptomology By Symptom Resolution Time in US High School Athletes: Findings From The National Athletic Treatment, Injury and Outcomes Network (NATION) High School Surveillance Program

Abstract

Context: Concussions incurred during high school athletics are a significant health concern, and studies examining concussions with symptom resolution time (SRT) of 15-28 days have been limited. Objective: To compare concussions that had a SRT of 15-28 days with concussions that had a SRT of >28 days among US High School athletes. Design: Descriptive epidemiology study. Setting: Secondary school athletic training clinics. Patients or other Participants: Secondary school athletes. Main Outcome Measure(s): Concussion frequency, symptom number, and symptom prevalence. Results: Among all 917 reported concussions (of which 50.8% had missing SRT), 88 had SRT recorded as 15-28 days and 29 had SRT recorded as >28 days. Greater frequencies of concussions with SRT >15 days were reported among boys' sports (n= 78) than girls' sports (n= 39). Boys' football (51.7%) and girls' basketball (11.5%) accounted for the largest proportions of all reported concussions with SRT of 15-28 days; boys' football (58.6%) accounted for the greatest proportion of concussions reported with SRT >28 days. The average number of symptoms in concussions with SRT of 15-28 days was 6.3±3.4 and 7.2±3.8 in those with SRT >28 days. The most frequently reported symptoms in concussions with both SRT of 15-28 days and >28 days were headache, dizziness, sensitivity to light, and difficulty concentrating. The prevalence of irritability was higher in concussions with SRT of 15-28 days as compared to concussions with SRT >28 days (26.1% vs. 13.8%); visual problems (48.3% vs. 35.2%) and hyperexcitability (24.1% vs. 15.9%) were more prevalent in concussion with SRT >28 days, although differences were not statistically significant. Conclusions: Symptom prevalence and total count were comparable between concussions with SRT of 15-28 days and >28 days with no statistically significant difference, suggesting symptom burden within these groups are more similar than they are different.