Presenting symptoms and recovery time among youth athletes with and without a history of concussion

Objective Determine if youth athletes with a history of concussion had more symptoms, higher symptom score, longer recovery, or were more likely to be diagnosed with Post-Concussion Syndrome (PCS) than those with no history of concussion. Design Retrospective chart review. Setting Paediatric, multi-disciplinary concussion. Participants 306 youth (mean 14.0 years, SD 2.3; 65.5% male) with an acute sport-related concussion. Intervention (or assessment of risk factors) Self-reported concussion history. Outcome measures Recovery days were days between concussion and medical clearance by the neurosurgeon. Medical clearance occurred after tolerating full-time school, completing return-to-play protocol, and absence of vestibulo-ocular dysfunction. Initial symptoms were reported on the Post Concussion Symptom Severity score (PCSS); symptom severity was the total PCSS score. The neurosurgeon diagnosed Post-Concussion Syndrome (PCS) using ICD-10 criteria of symptoms for at least 30 days. Main results Median number of initial symptoms was 5.5 (IQR: 1–10) for youth with no concussion history and 7.0 (IQR: 2–14) with a concussion history (p=0.04). Initial median PCSS score was 9 (IQR: 1–22) for youth with no concussion history and 13 (IQR: 3–34) with a concussion history (p=0.03). Median recovery days was 22 (IQR: 15–43) for those with no concussion history compared to 23 (IQR: 16–39) with a concussion history (p=0.41). There was no significant difference in subsequently being diagnosed with PCS (no concussion history: 40.1%, ?concussion history: 41.7%, p=0.73). Conclusions Despite a significantly higher initial symptom burden among those with a concussion history, there was no increased risk of protracted recovery or subsequent diagnosis of PCS. Competing interests None.