A - 145 Using a Multidimensional Symptom Model to Identify Persistent Post-Concussion Symptoms in Collegiate Athletes.

Abstract

Determine if a multidimensional (i.e., four-factor model) approach to post-concussion symptoms identifies more participants with persistent post-concussion symptoms after a sport-related concussion than a standard total score approach. Student-athletes (N = 1097; 61% Male; 59% White; 35% Freshmen; 14% Football athletes) from the Concussion Assessment, Research, and Education consortium completed the Sport Concussion Assessment Tool-3 Symptom Evaluation six months after a concussion. Scores ≥84th percentile compared to normative data were considered elevated. Elevation rates for total and subscale scores were compared to examine the utility of a multidimensional interpretation in identifying persistent symptoms. Six months after injury, 9.9% of athletes had symptom elevations on the total or subscale score. Overall, 8.1% of athletes were elevated on a subscale (i.e., physical = 3.9%, cognitive = 1.9%, affective = 2.3%, sleep-arousal = 1.7%) but not the total score, whereas just 1.8% were elevated on both a subscale and the total score. No athletes were elevated on the total score without being concurrently elevated on a subscale. Multidimensional symptom interpretations may aid in identifying cases of persistent post-concussion symptoms, detecting up to 8.1% of athletes with elevated symptoms that would not be detected by focusing on a total score alone. This study did not assess for daily symptoms, which is one of the consensus criteria for persistent post-concussion symptoms. Future research should evaluate whether specific subscale elevations correspond to functional deficits or adverse health outcomes in these athletes.