Sex, race, ADHD, and prior concussions as predictors of concussion recovery in adolescents

Brain Inj. 2020 May 11;34(6):809-817. doi: 10.1080/02699052.2020.1740942. Epub 2020 Mar 22.

Abstract

Objective: Concussions in adolescents are a growing public health concern as the popularity of high school sports increases. The aim of this study was to identify clinical (e.g., prior concussion, migraine history, learning disabilities/attention deficit hyperactivity disorders [ADHD]) and demographic factors (e.g., sex, race, health insurance, mechanism of injury/sport, education) that predict concussion recovery times.

Design: In a retrospective cohort study of adolescents 13-19 years old evaluated for an acute concussion (≤ 10 days from injury), recovery times were calculated from the date of concussive injury to the date of clearance to return to play or normal activities.

Results: The sample (N = 227) was primarily male (75%), and the median age was 15 years. Predictors of protracted recovery were ADHD (hazard ratio [HR] =.449, 95% confidence interval [CI] =.272-.741, p = .002) and prior concussion (HR =.574, 95% CI =.397-.828, p = .003) in all sex and race groups, while shorter recovery times were predicted by Hispanic and African American race (HR = 2.12, 95% CI = 1.30-3.46, p = .003), with White females as the reference group.

Conclusions: Further research is needed to examine the role of sex, race, ADHD, and concussion history on concussion outcomes.

Keywords: Concussion; adolescent; attention deficit disorder; race; recovery; sex.

MeSH terms

  • Adolescent
  • Athletic Injuries* / complications
  • Athletic Injuries* / epidemiology
  • Attention Deficit Disorder with Hyperactivity* / epidemiology
  • Attention Deficit Disorder with Hyperactivity* / etiology
  • Brain Concussion* / epidemiology
  • Female
  • Humans
  • Infant, Newborn
  • Learning Disabilities*
  • Male
  • Retrospective Studies