Abstract

Abstract Purpose Develop baseline normative reference data for the Sport Concussion Assessment Tool-3 (SCAT-3) Symptom Evaluation and examine how sex and preexisting conditions relate to the symptom domains endorsed by collegiate athletes. Methods Participants (N=24,696 collegiate student-athletes; 62.6% Male, 61.5% White, 9.2% Hispanic or Latino) from the Concussion Assessment, Research, and Education Consortium completed the SCAT-3 at a preseason baseline. Using a four-factor model (i.e., cognitive, physical, affective, and sleep-arousal), normative percentiles were calculated for each symptom subscale and the total score, with stratifications by sex and number of preexisting conditions. Symptom score distributions were compared across stratifications using Mann-Whitney U tests. Results Generally, female athletes and those with more preexisting conditions endorsed significantly higher symptoms at baseline (e.g., 84th percentile affective score: males=1, females=3, p<.001, r=.14; females with 1 condition=4, 3+ conditions=8, p<.001, r=11; males with 1 condition=3, 3+ conditions=7, p<.01, r=.06). This pattern held for all but the physical (i.e., no difference between individuals with 1 and 3+ conditions) and sleep-arousal (i.e., no difference between males with 1 and 3+ conditions) subscales. Conclusions Female sex and preexisting conditions were associated with higher symptom burden on most subscales. A female athlete with a symptom score of 10 may appear to have elevated post-concussion symptoms; however, if she has 3 preexisting conditions, this experience is average (i.e., 50th percentile) compared to others with 3+ conditions at baseline. She may benefit from intervention, but symptoms may not be attributable to a concussion. Normative reference data may help indicate symptom severity when baseline data are unavailable.

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