Disclosures: Sara Dykowski, MD: No financial relationships or conflicts of interest

Background and/or Objectives: While some studies have reported slower recoveries in athletes with two or more previous concussions, the literature describing the relationship between concussion history and recovery time is mixed. Furthermore, existing studies are limited by self-reported history and across-individual comparisons. Therefore, this study compared recovery times following subsequent concussions in the same athlete.

Design: Retrospective observational chart review.

Setting: Outpatient sports neurology clinic in a tertiary referral center.

Participants: 49 athletes (41% female) aged 7-21 years (median age= 15) who were treated for more than one concussion (98 unique injuries) between 1/2014 and 1/2021.

Interventions: Interventions: Not applicable.

Main Outcome Measures: Recovery time, as defined by days until clearance for unrestricted return to sport, was compared between athletes’ first vs. last concussions using Cox regression (primary). Secondary analyses used logistic regression to compare recoveries following first vs. last concussions as a binary (>30 days or >90 days) outcome.

Results: Mean recovery times were 42.7 vs. 31.8 days following first vs. last concussions treated in clinic, and did not differ over subsequent concussions, either in the primary time-to-event analysis (p=0.283) or by the proportion of athletes who took longer than 30 and 90 days to recover (p=0.441 and p=0.069, respectively). Fewer days from injury to initial clinic visit and lower Sport Concussion Assessment Tool (SCAT) symptom severity scores were both associated with faster recovery times in a multivariable Cox regression model.

Conclusions: Individual athletes treated in a single clinic for recurrent concussions did not have slower recovery times following subsequent injuries, while having a first visit more proximate to the injury date and a lower initial SCAT symptom severity score were both associated with faster recovery. These results do not support the hypothesis that athletes with history of multiple concussions take longer to recover following successive injuries.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/comparing-recovery-over-successive-injuries-in-athletes-with-recurrent-sport-related-concussion/