Initial Average Symptom Severity is a Better Predictor of Recovery following Concussion than Total Symptom Burden

Abstract

Abstract Purpose Symptom reports such as the Post-concussion Symptom Scale (PCSS) are common assessments following concussion. Patients with high symptom burden following a concussion take longer to recover. However, two patients could have a symptom burden of 30, which is high, but one patient has endorsed only 6 items for an average severity of 5; whereas, another patient has endorsed 15 items for an average severity of 2. The purpose of this study was to compare the association of different symptom outcomes (i.e., average symptom severity, total symptom severity [i.e., symptom burden] and total number of symptoms) on recovery time. Methods Participants included 109 (46-M/64-F) concussed patients aged 13–21 years (15.0±1.7) from a specialty clinic. Participants completed the PCSS and total symptom and average symptom severity scores were then calculated. Recovery time (i.e., date of injury to full medical clearance) was recorded. Pearson product-moment correlations and multiple regression (MR) were used to analyze the data. Results The results from the Pearson product-moment correlations indicated that all of the symptom outcomes were correlated. Only the average symptom severity score was correlated (r=.23, p<.05) with recovery time. Results from the MR for recovery time indicated that average symptom severity was associated with a longer recovery time (Beta=.40, t=2.2, p=.03). Conclusion Findings indicate that average symptom severity was the best predictors of recovery time, which is in contrast to the literature, and highlights the importance for clinicians to consider average symptom severity in prognosis following concussion.