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117 Trajectories of daily symptoms and associated factors among children and adolescents following concussion
  1. Lindsay Sullivan1,
  2. Menglin Xu2,
  3. Enas Alshaikh3,
  4. Keith Yeates4,5,
  5. H Gerry Hudson6,7,
  6. Jingzhen Yang3,7
  1. 1Discipline of Children’s Studies, School of Education, National University of Ireland Galway, Galway, Ireland
  2. 2Department of Internal Medicine, The Ohio State University, College of Medicine, Columbus, USA
  3. 3Center for Injury Research and Policy at The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, USA
  4. 4Department of Psychology, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Canada
  5. 5Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
  6. 6Biobehavioral Health Center, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, USA
  7. 7Department of Pediatrics, The Ohio State University, College of Medicine, Columbus, USA


Statement of Purpose Although concussion symptom presentation and duration vary greatly among youth, limited studies have used statistical approaches to account for such heterogeneity. This study aimed to 1) identify distinctive trajectories of daily post-concussion symptoms (PCS) from the acute post-injury period to symptom resolution among concussed youth aged 11–17 years and 2) examine demographic factors and acute PCS associated with the identified trajectories.

Methods/Approach We conducted a prospective cohort study among youth aged 11–17 with a physician-confirmed concussion. Participants were enrolled ≤72 hours of injury from an Emergency Department or concussion clinic at a large children’s hospital. Participants completed a daily survey that assessed PCS from enrolment until symptom resolution.

Results Of the 83 participants, most were male (n=54, 65.1%), injured during a sporting activity (n=70, 84.3%), and had PCS that persisted for >14 days post-injury (n=45, 54.2%). Results yielded four latent trajectory groups: 1) low acute/resolved PCS (n=39, 49.0%), 2) moderate/persistent PCS (n=19, 24.1%), 3) high acute/persistent PCS (n=13, 16.5%), and 4) high acute/resolved PCS (n=8, 10.1%). There were no significant associations between demographic factors and group membership except for symptom duration. A greater number of symptoms at injury were associated with an increased odds of being in the high acute/solved and high acute/persistent groups than the low acute/resolved group (OR=1.39, 95% CI=1.11, 1.74; OR=1.33, 95% CI=1.11, 1.60, respectively), as was a higher symptom severity at injury (OR=1.09, 95% CI=1.03, 1.15; OR=1.06, 95% CI=1.02, 1.11, respectively).

Conclusion Four concussion recovery trajectories were identified in this study thereby highlighting the importance of an individually tailored approach to treat and manage concussions in youth.

Significance Our findings may inform early, individualized treatment plans for youth with concussion, which, in turn may foster optimal recovery and reduce risk of prolonged recovery.

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