Comparison of Pre-injury and Clinical Characteristics Between Adolescents With Sport-Related Concussion and Non-Sport-Related Concussion Presenting to a Specialty Concussion Clinic

Objective To compare pre-injury and initial subacute clinical characteristics of adolescents with sport-related concussion (SRC) to those with non-sport-related concussion (non-SRC) who present to a specialty concussion clinic. Design Cross-sectional analysis of 136 adolescents 10-18 (Mean = 14.4 ± SD = 2.3) years presenting to a specialty concussion clinic 2-30 (M = 9.25 ± SD = 6.3) days post-injury. Main measures included 1) Clinical Interview, 2) Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), 3) Post-Concussion Symptom Scale (PCSS), 4) Vestibular/Ocular-Motor Screening (VOMS), 5) Screen for Child Related Anxiety Disorders - Child Version (SCARED-C), 6) Generalized Anxiety Disorder Assessment (GAD-7). Results 101 (74.3%) participants reported an SRC, and 35 (25.7%) reported a non-SRC. Adolescents presenting to the clinic with non-SRC were older, more likely to be female, presented to the clinic later, and reported headache/migraine and depression history ( p < 0.05). These adolescents also reported a higher PCSS symptom severity and GAD-7 total score compared to their SRC counterparts ( p < 0.01). Forward stepwise logistic regression revealed significant associations between non-SRC and headache/migraine history (adjusted [a]OR = 2.95, 95%CI = 1.17-7.47, p = 0.022), PCSS total score (aOR = 1.04, 95%CI = 1.02-1.06, p < 0.001), and days to clinic (OR = 1.08, 95%CI = 1.01-1.15, p = 0.029). Conclusions The most salient factors associated with non-SRC patients presenting to a specialty concussion clinic were a headache/migraine history, a longer time to clinic, and greater initial visit symptoms. These findings suggest that the factors that lead patients with SRC and Non-SRC to present to a specialty clinic differ, and that studies that are interested in differences in clinical characteristics based on mechanism of injury will need to address substantial referral differences between these two populations that would confound such findings.