Differences In Baseline Concussion Symptom Reporting Across Age And Gender

Abstract

PURPOSE: Previous studies have identified significant differences across age and gender in post-concussion symptoms reporting, with female and high school aged athletes reporting both a higher number of symptoms and a greater symptom severity. This study evaluates differences in baseline symptom reporting across age group and gender. METHODS AND STUDY DESIGN: Between 2007-2019, concussive symptoms were reported by middle school (MS), high school (HS) and collegiate athletes (CA) utilizing the post-concussion symptom scale at baseline. Excluded athletes included those with invalid testing, age > 24y or < 10y, learning disabilities, ADHD, autism, or a prior history of concussion. ANOVA was performed assessing the total number of symptoms and the total symptom severity score as reported by age group, and gender. Results: (1000)25,694 athletes (60% male and 40% female) were included: 4.6% MS (n=1,179), 89.7% HS (n=23,047) and 5.7% CA (n=1,468). Among the different age groups, there were no significant differences in number of symptoms (p=0.21) or symptom severity score (p=0.48). However, there were significant differences noted between male and female athletes. Males reported fewer symptoms than females (1.75 ± 3.0 vs 2.50 ± 3.6, p<1x10-70). Males also reported a lower baseline symptom severity (3.34 ± 6.7 vs 4.96 ± 8.7, p<1x10-62). This difference between genders held true across age levels with significant differences in the number of baseline symptoms reported (MS p<0.001, HS p<1x10-60, CA p<0.001) and symptom severity score (MS p<0.001, HS p<1x10-51, CA p<0.01). CONCLUSION: This study identifies symptom differences between genders at baseline. These baseline differences may contribute to the post-concussive discrepancies seen previously. In contrast, baseline differences are not present between age groups possibly suggesting a pathophysiologic underpinning to the post-concussive discrepancies of higher total symptoms and higher severity noted in high school athletes. Significance of Findings: Significant differences in concussive symptom reporting by age level, despite comparable baselines shown here, may reflect pathophysiologic, rather than reporting discrepancies, necessitating specific evaluation and management strategies across age levels.