Clinical characteristics, referral patterns and time to recovery in youth and adults following a sport-related concussion (src)

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Abstract

Objective

To describe the clinical characteristics, referral patterns and time to recovery in an acute sport-related concussion (SRC) clinic population.

Design

Prospective Case Series

Setting

Acute Sport Concussion Clinic (ASCC)

Participants

Patients aged 13-60 years seen within 4 weeks of SRC at the ASCC from September 2015–April 2016.

Outcome measures

Frequency, proportions, medians and interquartile ranges (IQR) were used to describe sex, age group, time from injury to assessment, referral sources, time to recovery (days), referrals to additional services, and attrition.

Results

ASCC assessments were requested by 111 patients a median of 9 days (IQR:4-17) post-concussion [33% female; 60 children [median age 15 years (IQR:14-16)], 51 adults [median age 31 years (IQR:21-42)]; attrition rate=10%]. Referral sources included: self-referral [n=94 (85%)], emergency department [n=9 (8%)], primary care physician [n=7 (5%)], and athletic therapist (n=1). Initial assessment occurred a median of 7 days (IQR:2-9) following the evaluation request. Patients underwent a standardised assessment including symptom scores, neurological, cervical spine and vestibulo-ocular screening a median of 17 days (IQR:9-25) post-concussion. There were 94 (85%) patients with clinical findings of cervical spine and/or vestibulo-ocular dysfunction. Treatment was received by 71/94 (76%) of patients with observed dysfunction. Medical clearance to return to play occurred a median of 30 days (IQR:21-107) post-concussion (n=51) .

Conclusions

A novel direct-access clinic specific to SRC assists in early triage, leading to expedited assessment, management and treatment in the early post-concussion period. Focused assessment assists in management and recovery with accelerated referral to appropriate services.

Competing interests

None.

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