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Socioeconomic status and outcomes after sport-related concussion: a preliminary investigation.

作者信息

Zuckerman Scott L, Zalneraitis Brian Holt, Totten Douglas J, Rubel Kolin E, Kuhn Andrew W, Yengo-Kahn Aaron M, Bonfield Christopher M, Sills Allen K, Solomon Gary S

机构信息

Vanderbilt Sports Concussion Center and.

Department of Neurological Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee; and.

出版信息

J Neurosurg Pediatr. 2017 Jun;19(6):652-661. doi: 10.3171/2017.1.PEDS16611. Epub 2017 Mar 24.


DOI:10.3171/2017.1.PEDS16611
PMID:28338445
Abstract

OBJECTIVE A significant proportion of patients experience long-term symptoms after sport-related concussion (SRC), and several factors have been associated with this protracted recovery. Limited data exist on the role of socioeconomic status (SES) on SRC outcomes. The objective in this study was to conduct a preliminary investigation to determine the effect of SES on outcomes after SRC in student-athletes treated at a regional sports concussion center. METHODS A retrospective cohort study of 282 middle school, high school, and collegiate student-athletes was conducted. An attempt was made to contact all patients seen at a comprehensive SRC center between January 2012 and May 2015 for in-depth interviews. Subsequent demographic data were collected. The SES was defined as follows: cost of living percentile, median income percentile, percentage of college graduates, percentage of homeowners, county type, and insurance status. Outcomes after SRC were defined as follows: days of symptom duration, days of missed school, and days of missed practice. Statistically controlled covariates included sex, race, age, body mass index, concussion history, neuropsychiatric history, and type of sport. RESULTS A total of 282 student-athletes consented and were studied. The median age was 15.8 years (range 11.6-22.2 years) and 61.4% of student-athletes were male. A previous concussion was incurred by 34.0% of student-athletes. Football was the most common sport (32.3%), followed by soccer (16.3%), and basketball (15.6%). The median symptom duration was 21 days (range 1-365 days); the median missed school days was 2 (range 0-90 days); and median for days of missed practice was 10 (range 0-150 days). After multivariate Cox regression analysis, no relationship between any of the 6 SES variables and symptom duration or missed practice was seen. However, individuals with private insurance had more missed days of school than those with public insurance (hazard ratio 0.46, 95% CI 0.26-0.83, p = 0.009). CONCLUSIONS In a preliminary study of middle school, high school, and collegiate student-athletes, SES had no impact on the outcomes of symptom duration and missed practice. However, for individuals with private insurance, the return to school was slower than for those with public insurance. This pilot study reveals the complex relationship between SES and SRC recovery, which demands further study with more accurate and validated assessments of SES.

摘要

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引用本文的文献

[1]
Comparison of Urban versus Industry Normative Values of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT™).

Int J Environ Res Public Health. 2024-2-21

[2]
Update on Pediatric Mild Traumatic Brain Injury in Rural and Underserved Regions: A Global Perspective.

J Clin Med. 2023-5-6

[3]
Clinical Outcome Following Concussion Among College Athletes with a History of Prior Concussion: A Systematic Review.

Sports Med Open. 2022-10-29

[4]
Socioeconomic status and injury history in adolescent athletes: Lower family affluence is associated with a history of concussion.

J Clin Transl Res. 2022-7-18

[5]
Influence of concussion history and age of first concussion on visio-vestibular function.

J Sci Med Sport. 2022-9

[6]
Fair play? Participation equity in organised sport and physical activity among children and adolescents in high income countries: a systematic review and meta-analysis.

Int J Behav Nutr Phys Act. 2022-3-18

[7]
Race and Concussion: An Emerging Relationship.

Ochsner J. 2020

[8]
Characteristics and outcome of severe traumatic brain injuries based on occupational status.

Eur J Trauma Emerg Surg. 2021-12

[9]
Baseline profiles of auditory, vestibular, and visual functions in youth tackle football players.

Concussion. 2020-1-14

[10]
Combining Nonclinical Determinants of Health and Clinical Data for Research and Evaluation: Rapid Review.

JMIR Public Health Surveill. 2019-10-7

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