Characterizing the profiles of patients with acute concussion versus prolonged post-concussion symptoms in Ontario

Abstract

Identifying vulnerability factors for developing persisting concussion symptoms is imperative for determining which patients may require specialized treatment. Using cross-sectional questionnaire data from an Ontario-wide observational concussion study, we compared patients with acute concussion (≤ 14 days) and prolonged post-concussion symptoms (PPCS) (≥ 90 days) on four factors of interest: sex, history of mental health disorders, history of headaches/migraines, and past concussions. Differences in profile between the two groups were also explored. 110 patients with acute concussion and 96 patients with PPCS were included in our study. The groups did not differ on the four factors of interest. Interestingly, both groups had greater proportions of females (acute concussion: 61.1% F; PPCS: 66.3% F). Patient profiles, however, differed wherein patients with PPCS were significantly older, more symptomatic, more likely to have been injured in a transportation-related incident, and more likely to live outside a Metropolitan city. These novel risk factors for persisting concussion symptoms require replication and highlight the need to re-evaluate previously identified risk factors as more and more concussions occur in non-athletes and different risk factors may be at play.

Figure 1

Radar plot for profiles of patients age ≥ 16 with acute concussion and PPCS based on variables of interest (Table 3). Scale is the percentage of patients who are female, or who answered yes to having a history of headache/migraine, a history of mental health disorders, or previous concussions.

Figure 2

Radar plot of mean summed SCAT5 symptom scores for variables subcategorized by cognitive, emotional, somatic, and fatigue/sleep comparing patients age  ≥ 16 with acute concussion (n = 99) and with PPCS (n = 43).