Abstract
Abstract Purpose To investigate predictors of prolonged recovery after concussion in collegiate athletes. Method Data for this cross-sectional, retrospective chart review of collegiate athletes diagnosed with concussion (n = 1044 concussions), who were on average 20-years of age, were collected during the 2015–16 to 2019–20 athletic seasons. The majority (92% [959/1044]) of athletes achieved symptom resolution at rest and made an unrestricted return-to-sport by 23 days after injury. The remaining athletes (8% n = 85[36.5% female]), with symptoms that lasted beyond 23 days after concussion were considered to have prolonged recovery. Linear regression was used to determine predictors of prolonged recovery; times to symptom-freedom and unrestricted return-to-sport were dependent variables and variables associated with medical and psychiatric history, and some post-concussion symptoms, were independent variables. Results Athletes with prolonged recovery generally recovered on median (interquartile range) 32 (17) days after injury. The majority (42% [36/84]) participated in football. A self-reported history of anxiety [Β = 0.577, p = 0.01], depression [Β = 0.462, p = 0.04], a history of headache [Β = 0.84, p < 0.001], and migraine [Β = 0.761, p < 0.001] were predictors of prolonged recovery. A history of prior concussion and higher symptom burden immediately after concussion did not predict prolonged recovery (all p > 0.05). Conclusions Similar to related research, our findings suggest a self-reported history of psychiatric conditions, headache, and migraine associate with prolonged recovery in collegiate athletes. Our findings highlight the importance of mood symptom monitoring, early psychological intervention, and management of headache following concussion. Importantly, the majority of our sample, inclusive of collegiate athletes with prolonged recovery, recovered approximately one-month after injury.
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