Konstantinides Niki A, Murphy Sean M, Whelan Bridget M, Harmon Kimberly G, Poddar Sourav K, Hernández Theresa D, Rowe Rachel K
Department of Integrative Physiology, University of Colorado Boulder, UCB 354, Boulder, CO, 80309, USA.
Cumberland Biological and Ecological Researchers, Longmont, CO, USA.
Sports Med Open. 2024 Apr 2;10(1):31. doi: 10.1186/s40798-024-00699-4.
Sport-related concussion (SRC) is a heterogenous injury that often presents with varied symptoms and impairment. Recently, research has focused on identifying subtypes, or clinical profiles of concussion to be used in assessing and treating athletes with SRC. The purpose of this study was to investigate sex differences in clinical profiles, recovery duration, and initial symptom severity after SRC in a cohort of collegiate athletes in the Pacific-12 Conference (Pac-12).
This prospective cohort study examined post-SRC symptoms, recovery, and return-to-play times using data from the Pac-12 CARE Affiliated Program and Pac-12 Health Analytics Program. Clinical profiles reported by student-athletes were defined by the number (> 50%) of specific symptoms frequently reported for each profile. Generalized linear mixed models were used to examine associations among sex, clinical profiles, time-to-recovery, and return-to-play times.
479 concussion incidents met inclusion criteria. The probabilities of initial presentation of each clinical profile, initial injury severity scores, and recovery times within a profile did not differ between sexes (p = 0.33-0.98). However, both males and females had > 0.75 probabilities of exhibiting cognitive and ocular profiles. Initial injury severity score was a strong nonlinear predictor of initial number of clinical profiles (p < 0.0001), which did not differ between sexes. The number of clinical profiles was also a nonlinear predictor of time-to-recovery (p = 0.03) and return-to-play times (p < 0.0001).
Initial symptom severity was strongly predictive of the number of acute clinical profiles experienced post-SRC. As the number of clinical profiles increased, time-to-recovery and time to return-to-play also increased. Factors other than sex may be better associated with acute symptom presentation post-concussion as no sex differences were found in reported clinical profiles or recovery. Understanding the number and type of clinical profiles experienced post-SRC may help inform concussion diagnostics and management.
与运动相关的脑震荡（SRC）是一种异质性损伤，常表现出各种症状和功能障碍。最近，研究集中于识别脑震荡的亚型或临床特征，以用于评估和治疗患有SRC的运动员。本研究的目的是调查太平洋十二校联盟（Pac-12）的一组大学生运动员在发生SRC后临床特征、恢复持续时间和初始症状严重程度方面的性别差异。
这项前瞻性队列研究使用Pac-12 CARE附属项目和Pac-12健康分析项目的数据，检查了SRC后的症状、恢复情况和重返比赛时间。学生运动员报告的临床特征由每个特征中经常报告的特定症状数量（>50%）定义。使用广义线性混合模型来检查性别、临床特征、恢复时间和重返比赛时间之间的关联。
479起脑震荡事件符合纳入标准。每种临床特征的初始表现概率、初始损伤严重程度评分以及特征内的恢复时间在性别之间没有差异（p = 0.33 - 0.98）。然而，男性和女性表现出认知和眼部特征的概率均>0.75。初始损伤严重程度评分是初始临床特征数量的强非线性预测因子（p < 0.0001），在性别之间没有差异。临床特征数量也是恢复时间（p = 0.03）和重返比赛时间（p < 0.0001）的非线性预测因子。
初始症状严重程度强烈预测SRC后经历的急性临床特征数量。随着临床特征数量的增加，恢复时间和重返比赛时间也增加。由于在报告的临床特征或恢复方面未发现性别差异，性别以外的因素可能与脑震荡后的急性症状表现更好相关。了解SRC后经历的临床特征数量和类型可能有助于为脑震荡的诊断和管理提供信息。
