Abstract
Abstract Purpose This study examined relationships among concussion clinical profiles with patient demographic and clinical factors and the prognostic utility of the CP Screen tool at initial visit for prolonged recovery (>28 days). Methods 297 participants with concussion were selected through convenience sampling for this retrospective cohort study (9-68 years old, 59.3% males, 71.7% sport-related concussion). At initial visit in UPMC clinics, participants of the original study completed the CP Screen along with the ImPACT, PCSS, VOMS, as part of standard care. Clinical profiles (anxiety/mood, cognitive/fatigue, posttraumatic migraine, vestibular, ocular) were endorsed via CP Screen criteria. Participants’ demographic (age, sex, mechanism of injury) and clinical (psychiatric, migraine, ADHD/LD, concussion histories) factors were examined. Results Females endorsed more clinical profiles (M=1.20, SD=1.54) than males (M=.60, SD=1.13) (p<.001). Psychiatric history predicted endorsement of anxiety/mood profile (OR=3.29, 95% CI [1.41, 7.69], p<.01), controlling for migraine, ADHD/LD, and concussion histories. Vestibular profile, controlling for other clinical profiles, predicted prolonged recovery (OR=3.93, 95% CI [1.52, 10.22], p<.01). Exploratory analysis for cognitive/fatigue profile as predictor of prolonged recovery revealed statistical significance (OR=2.16, 95% CI [1.01, 4.62], p<.05). Conclusions At initial visit, clinicians may anticipate females to present more symptomatic with clinical profiles than males and expect anxiety/mood profile endorsement by those with pre-existing psychiatric problems. Clinicians may also need to closely monitor patients initially endorsing vestibular or cognitive/fatigue profiles as they are more likely to experience an extensive recovery.
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