Sport concussion assessment tool-2 (SCAT2) scores in the acute phase following concussion in high school athletes

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Abstract

Objective

To investigate changes in SCAT2 scores in high school athletes in the first 10 days post-concussion.

Design

Within subjects, repeated measures.

Setting

High school athletic facilities.

Patients

119 high school athletes who sustained a sport-related concussion diagnosed by their athletic trainer (102 males, 15 females, and 2 missing, age=15.8±1.2, grade=10.0±1.0 level).

Interventions

The SCAT2 was administered during a preseason baseline, day of injury (DOI), and days 3 (D3) and 10 (D10) post-concussion. The SCAT2 total score is calculated by summing each component score, and has a maximum of 100 points.

Main Outcome Measures

Day of testing served as the independent variable and the dependent variable was SCAT2 total score. Analyses were conducted using a generalised estimating equations approach to accommodate repeated measures of the same participants. An inverse Gaussian distribution and identity link were specified, along with robust variance estimators. Follow-up pairwise tests employed a Bonferroni correction.

Results

The omnibus test was significant (p<0.001). Scores at DOI (73.5, 95% CI 70.8 to 76.1) were significantly lower than BL (86.0, 95% CI 84.8 to 87.3). D3 scores (79.8, 95% CI 77.2 to 82.3) remained significantly lower than BL, but were significantly higher than DOI. Scores at D10 (88.8, 95% CI 87.3 to 90.3) were significantly higher than DOI, D3, and BL.

Conclusions

SCAT2 scores decreased significantly during the first 3 days post-concussion, demonstrating impairments in a composite score that includes symptoms, mental status, and balance. Deficits in the SCAT2 recovered to levels above baseline by D10, indicating a resolution of concussion related impairments.

Acknowledgements

This study was funded by a grant from the National Operating Committee for Standards on Athletic Equipment (NOCSAE).

Competing interests

None.

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