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Abstract Purpose More severe symptomatology post-concussion is predictive of prolonged recovery; however, it is unclear whether certain symptom clusters are associated with increased risk for protracted recovery. This study examined the relationship between five symptoms clusters on the SCAT-3 and risk for prolonged recovery from sports-related concussion. Method 1444 (F = 619) collegiate athletes completed post-concussion neuropsychological evaluation within 24 to 48 hours following injury. SCAT-3 scores were separated into clusters based on previous research (Cognitive, Physical, Emotional, Insomnia, Ungrouped). Given that the clusters consisted of different numbers of items, an average item score was created for each cluster. Athletes were separated into two groups based on number of days to return-to-play, using 28 days as the cutoff. Logistic regression was conducted with recovery type (Typical/Prolonged) as the outcome, and the five SCAT-3 symptom clusters as predictors. Results Only the SCAT-3 Physical cluster was significantly associated with recovery (p 0.001). Specifically, athletes endorsing higher acute physical symptoms were at increased risk for prolonged return-to-play, such that a one-point increase in average item score on the SCAT-3 Physical symptom cluster was associated with 90.81% increased risk (O/R = 1.91) for prolonged recovery. Conclusions Athletes endorsing more severe physical symptoms 24 to 48 hours post-concussion were at significantly increased risk for prolonged recovery, though other symptom clusters did not infer the same risk. Findings suggest differential risk associated with symptom presentation; athletes endorsing significant physical symptoms in the acute phase of injury would likely benefit from targeted treatment to ameliorate these symptoms and, potentially, reduce risk for complicated recovery.
Thomas et al. (Sat,) studied this question.