Sport-related concussion: factors associated with prolonged return to play.

OBJECTIVE

To assess predictive value of concussion signs and symptoms based on return-to-play timelines.

DESIGN

Physician practice study without diagnosis that includes presentation, initial and subsequent treatment, and management of concussion.

SETTING

National multisite primary care sports medicine provider locations.

PARTICIPANTS

Twenty-two providers at 18 sites; 101 athletes (91 men, 10 women in the following sports: 73 football, 8 basketball, 8 soccer, 3 wrestling, 2 lacrosse, 2 skiing, 5 others; 51 college, 44 high school, 4 professional, and 2 recreational).

MAIN OUTCOME MEASUREMENTS

Duration of symptoms, presence of clinical signs, and time to return to play following concussion.

RESULTS

One hundred one concussions were analyzed. Pearson chi2 analysis of common early and late concussion symptoms revealed statistical significance (P < 0.05) of headache >3 hours, difficulty concentrating >3 hours, any retrograde amnesia or loss of consciousness, and return to play >7 days. There appeared to be a trend in patients with posttraumatic amnesia toward poor outcome, but this was not statistically significant.

CONCLUSIONS

When evaluating concussion, symptoms of headache >3 hours, difficulty concentrating >3 hours, retrograde amnesia, or loss of consciousness may indicate a more severe injury or prolonged recovery; great caution should be exercised before returning these athletes to play.