657 MEP041 – Fast-tracking concussion recovery in elite athletes: the power of early multidisciplinary secondary prevention

AbstractBackground Over the past two decades, guidelines for early recognition and management of sport-related concussions (SRC) have evolved, reflecting advances in evidence-based practices. Their specific impact on recovery in elite level athletes remains relatively unexplored.Objective to investigate the epidemiology of concussions in elite athletes emphasizing secondary prevention through unrestricted multidisciplinary care.Design observational cohort study Setting data obtained from athletes visiting a national sports institute medical clinic in CanadaParticipants a total of 161 concussions were recorded over four years (2018 to 2022) involving 87 females and 74 males (mean age 20.5±4.6 years old) across 28 sports. Seven sports groups had unrestricted access to the national sports institute's concussion clinic. All participants competed in national or international events.Assessment of Risk Factors Data included concussion counts, sex, delay to first consultation, history of previous concussions, SCAT5 assessments including SCAT5 risk modifiers, and clinical expert consultations.Main Outcome Measurements Our primary focus was return to performance measured by days to complete stepwise rehabilitation (e.g., steps 1–6) and achieve symptom-free, physician-authorized competition return.Results athletes with unrestricted access to multidisciplinary care had a significantly shorter median return to performance of 26.0 days (IQR=25.0), compared to external visitors (50.0 days, IQR=63.5) (p<0.01). Delayed access affected external visitors more, with a median delay of 15.5 days (IQR=29.3) vs 4.0 days (IQR=11.0) for those with unrestricted access (p<0.01). Notably, known risk factors did not significantly affect return to performance, however males and females exhibited different clinical trajectories. Conclusions Elite athletes require longer recovery periods than previously reported in broader populations. Early multidisciplinary care access emerges as crucial in reducing concussion recovery times, underscoring the importance of prevention and rapid intervention in elite sports. Multidisciplinary care demonstrates potential for secondary prevention of SRC in elite athletes.