Incidence, Clinical Course, and Predictors of Prolonged Recovery Time Following Sport-Related Concussion in High School and College Athletes
Incidence, Clinical Course, and Predictors of Prolonged Recovery Time Following Sport-Related Concussion in High School and College Athletes
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DOI：
10.1017/s1355617712000872
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发表时间：
2013-01-01
影响因子：
2.6
通讯作者：
Kelly, James P.
中科院分区：
文献类型：
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作者：
McCrea, Michael;Guskiewicz, Kevin;Kelly, James P.
运动相关脑震荡（SRC）通常在几天内临床恢复，但长期症状的报告很常见。我们调查了一个大型队列（n = 18，531）的运动员赛季在10年内恢复时间延长的发生率。共有570名脑震荡运动员（3.1%）和166名对照者接受了损伤前症状，神经认知功能和平衡的基线评估，在脑震荡后立即，3小时，1，2，3，5，7和45或90天重新评估。脑震荡运动员根据症状恢复时间分为典型（7天内）或延长（> 7天）恢复组。10%的运动员（n = 57）症状恢复时间延长，这也与神经认知测试的快速恢复有关（p <0.001）。在受伤后45-90天，长期恢复组报告症状加重，认知或平衡测试没有缺陷。恢复时间延长与意识丧失[比值比（OR），4.15; 95%可信区间（CI），2.12-8.15]、创伤后遗忘（OR，1.81; 95% CI，1.00-3.28）和更严重的急性症状（p <0.0001）相关。这些结果表明，一小部分运动员在SRC后可能会出现超出典型恢复窗口的症状和功能障碍，并且恢复时间延长与更严重损伤的急性指标相关。(JINS，2013，19，22-33）
Sport-related concussion (SRC) is typically followed by clinical recovery within days, but reports of prolonged symptoms are common. We investigated the incidence of prolonged recovery in a large cohort (n = 18,531) of athlete seasons over a 10-year period. A total of 570 athletes with concussion (3.1%) and 166 controls who underwent pre-injury baseline assessments of symptoms, neurocognitive functioning and balance were re-assessed immediately, 3 hr, and 1, 2, 3, 5, 7, and 45 or 90 days after concussion. Concussed athletes were stratified into typical (within 7 days) or prolonged (> 7 days) recovery groups based on symptom recovery time. Ten percent of athletes (n = 57) had a prolonged symptom recovery, which was also associated with lengthier recovery on neurocognitive testing (p < .001). At 45-90 days post-injury, the prolonged recovery group reported elevated symptoms, without deficits on cognitive or balance testing. Prolonged recovery was associated with unconsciousness [odds ratio (OR), 4.15; 95% confidence interval (CI) 2.12-8.15], posttraumatic amnesia (OR, 1.81; 95% CI, 1.00-3.28), and more severe acute symptoms (p < .0001). These results suggest that a small percentage of athletes may experience symptoms and functional impairments beyond the typical window of recovery after SRC, and that prolonged recovery is associated with acute indicators of more severe injury. (JINS, 2013, 19, 22-33)