A - 144 Prior Concussions and Symptom Elevation Rates in Collegiate Student-Athletes at Preseason Baseline.

Abstract

Assess how prior concussions are related to baseline symptom endorsement using a four-factor model of post-concussion symptoms (i.e., cognitive, sleep-arousal, physical, and affective). Athletes from the Concussion Assessment, Research, and Education consortium (N&#3f7,370; 64% Male; 62% White; 36% Freshmen; 15% Football players) with at least one prior concussion were administered the Sport Concussion Assessment Tool-3 Symptom Evaluation at baseline. Subscale and total scores ≥84th percentile were considered elevated based on normative reference data from uninjured participants matched on gender and number of preexisting conditions. The symptoms of Headache, Pressure in head, Sensitivity to light, and Difficulty remembering were endorsed at a significantly higher rate (ps < 0.001, OR range = 1.35 to 1.40) by those with two or more prior concussions compared to those with one prior concussion. Approximately 22% of athletes had an elevated subscale score without an elevated total score. In contrast, no athletes were elevated on the total score without also being elevated on a subscale score, and 18% of athletes were elevated on both a subscale and the total score. The physical subscale was consistently the most frequent exclusively elevated subscale in the full sample (cognitive = 4%; physical = 10%, sleep-arousal = 6%, affective = 7%). Prior concussion status is related to item-level symptom endorsement among collegiate athletes at preseason baseline. A multidimensional approach to symptom interpretation identified a sizeable number of athletes (i.e., 22%) with significant symptoms that were not captured by a total score elevation. Most athletes with an elevated subscale score (i.e., 55%) were experiencing physical symptoms.