Friday, April 19, 2024

1… 2… 3… Prior Concussions Predict Persistent Postconcussion Signs in Youth


Affiliation of Concussion Historical past and Extended Restoration in Youth.

Chizuk HM, Cunningham A, Horn EC, Thapar RS, Willer BS, Leddy JJ, Haider MN. Clin J Sport Med. 2022;32(6):e573-e579. doi:10.1097/JSM.0000000000001044

https://journals.lww.com/cjsportsmed/Summary/2022/11000/Association_of_Concussion_History_and_Prolonged.19.aspx

Take-Residence Message

Athletes with three or extra prior concussions had been extra prone to develop persistent postconcussive signs and take longer to get better than friends with fewer earlier concussions.

Background

Persistent postconcussive signs are outlined in adults as signs lasting longer than 10 to 14 days; in kids, it has been outlined as taking longer than one month to get better. A historical past of three or extra concussions is related to an extended restoration in adults. Nonetheless, it stays unclear if that is true amongst pediatric sufferers.

Examine Objectives

The authors investigated if a higher variety of prior concussions elevated the danger of persistent postconcussive signs in pediatric sufferers.

Strategies

The authors collected affected person information prospectively from three sports activities medication clinics close to Buffalo, New York. Sufferers had been between 8 and 18 years previous, identified with a concussion inside 14 days of the damage, had a documented variety of prior concussions, and had been handled till clinically recovered. The researchers outlined restoration as signs returning to regular at relaxation, regular bodily examination, and the flexibility to train and return to high school with out symptom exacerbation. The researchers calculated restoration time because the distinction between days from damage and when members recovered. Physicians recorded the variety of physician-diagnosed concussions or undiagnosed concussions that they deemed dependable based mostly on a affected person’s historical past.

Outcomes

The authors recruited 284 kids, with 270 used within the ultimate evaluation. Fifteen kids had three or extra prior concussions. Whereas 32 to 38% of youth with a historical past of 0 to 2 prior concussions developed persistent signs, two-thirds of these with 3 or extra concussions developed persistent signs. The researchers discovered {that a} reduce level of ≥ 3 or ≥4 concussions had the perfect prediction charge of who would finally develop persistent signs.

Viewpoints

These outcomes show that pediatric sufferers with a historical past of three or extra concussions usually tend to develop persistent signs. It is going to be attention-grabbing to see if these findings could be replicated in a examine with extra individuals with 3 or extra concussions. Nonetheless, these findings might maintain up effectively as a result of they agree with earlier analysis amongst adults who’ve skilled concussions.

Medical Implications

Clinicians ought to use this info to coach sufferers, notably those that have sustained a number of concussions, that their restoration is extra prone to take longer than their earlier concussions. It could be useful to tell school-based clinicians and directors {that a} affected person has a historical past of a number of concussions and may have an extended time to get better and extra educational lodging.

Questions for Dialogue

  1. Do different preinjury historical past elements affect a affected person’s chance of sustaining a concussion?

Written by Mitchell Barnhart
Reviewed by Jeffrey Driban

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