1128 - Retrospective Review of Symptomatology and Functional Outcomes of Repeat Concussion in Adolescents

Objectives: Adolescents are at the highest risk for both single and repeat concussions. It is understood that a single concussion increases the risk for subsequent concussion, but currently, there is no research addressing the impact on long-term function outcomes, such as return to school and play.

This study provides a retrospective review of clinical data in adolescents with repeat concussions over a 2-year period.

Design: Chart review was performed on patients ages 12-18 (n=134) presenting to The Center Concussion Clinic. Patients were grouped into no prior concussion (NP), 1 prior concussion (1P), or ≥ 2 prior concussions (2P). Outcome measures included initial symptom severity score based on post-concussion symptom inventory (PSCI), days to headache recovery, days to return to full school (RTS) without accommodations, and days to return to play (RTP) without restrictions. ANOVA was used to assess for statistical differences between the 3 groups.

Results: 134 patients were included in this review (NP=70, 1P=39, 2P=25). Results of PSCI demonstrated no significant difference between the 3 groups in initial symptom severity. Days to headache recovery was longest in 2P group (88 days) (NP=34 days, 1P=45 days) (p=.049). RTP was longest in 1P group (73 days) (NP=38 days, 2P =33 days) (p=0.026). RTS was longest in 1P group on average (42 days) (NP=30 days, 2P=41 days) but was not statistically significant (P=0.643).

Conclusions: This review found prolonged headache burden with repeat concussion, consistent with prior research. Surprisingly, initial symptom severity was similar across the three groups. There was an unexpected finding of a much longer return to play in the 1P group compared to NP and 2P. The RTS data was limited, but not significant. Further analysis is needed to better characterize the functional implications of repeat concussions in this high-risk population.