Immediate vs delayed concussion reporting: role of concussion knowledge, attitudes, and symptoms

Objective The purpose of this study was to identify if concussion knowledge and attitude scores differed between collegiate student-athletes with immediate or delayed concussion reporting.Methods There were 67 student-athletes who were divided into ‘Immediate’ (N = 35) and ‘Delayed’ (N = 32) reporting of non-obvious concussions. Participants completed the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) questionnaire, which is composed of a concussion knowledge index (CKI, 0–24) and attitude index (CAI, 15–75) with higher scores reflecting better performance. Groups were compared with a pooled two-sample t test, and a binary logistic regression was performed with three predictors (CKI, CAI, Symptoms).Results There were no group differences for CKI Score (Immediate: 20.2 ± 2.9 vs Delayed: 19.8 ± 2.5; t(65) = 0.68, p = 0.501, d = 0.17), but the Delayed group had a significantly higher CAI score (Immediate: 51.9 ± 6.8 vs Delayed: 55.8 ± 9.1, t(65) = −2.00, p = 0.050, d = −0.49). Higher CKI (OR: 1.31, 95% CI [1.03, 1.75]) and Symptoms (OR: 1.05, 95% CI [1.00, 1.09]) increased the unit odds of Immediate report, but higher (safer) CAI had lower unit odds of Immediate report (OR: 0.89, 95% CI [0.79, 0.98]).Conclusion Concussion reporting remains a complex process which likely includes intrinsic (i.e. knowledge and attitude) factors, non-modifiable factors (e.g. symptoms), and environmental factors which challenges sports medicine clinician’s ability to increase athlete’s self-report of potential concussions.