Outcomes after sport-related concussion: does socioeconomic status matter?

Abstract

ObjectiveTo determine the impact of socioeconomic status (SES) on outcomes after sport-related concussion (SRC) in a regional sports concussion centre.DesignRetrospective cohort study.SettingComprehensive sports concussion centre.Participants282 youth, high school, and collegiate student-athletes.InterventionAll patients seen at a comprehensive sports concussion centre were contacted after their injury for in-depth telephone interviews. Subsequent demographic data was also collected.Outcome measuresSES was defined based on six variables: cost of living percentile, median income percentile, % college graduates, % homeowners, county type, and insurance. Outcomes after SRC were defined as the following three variables: days of symptom duration, days of missed school, and days of missed practice.Main resultsA total of 282 student-athletes were studied. The median age was 15.8 years (range 11.6–22.2). American football was the most common sport (32.2%). After multivariate cox-regression analysis, no relationship between SES and symptom duration or missed practice was seen. For the outcome of missed school, insurance status had a significant relationship, where those with private insurance had fewer missed days of school than those with public insurance (HR 0.46, 95% CI: 0.26–0.83, p=0.009).ConclusionsIn a regional cohort of youth, high school and collegiate student-athletes, SES had largely no impact on the outcomes of symptom duration, missed school, and missed practice. The only significant relationship was that those with private insurance returned to school quicker than those with public insurance, which may represent increased access to rehabilitation resources after SRC.Competing interestsNone.GS Solomon receives consulting fees from the Tennessee Titans (NFL), the Nashville Predators (NHL), and the athletic departments of several universities, all fees paid to institution. In addition he is a member of the ImPACT Scientific Advisory Board and receives reimbursement for expenses to board meetings.AK Sills is a consulting physician to the Nashville Predators (uncompensated) and also serves as an unaffiliated neurotrauma consultant for the NFL.