Do patients who receive clinical care sooner after concussion recover faster? In this
cross-sectional study of 162 adolescent and young adult athletes with concussion,
those who initiated clinical care earlier (within 7 days) recovered faster and were
less likely to have prolonged (≥30-day) recovery times than those who initiated care
later (at 8-20 days). Per this study, early initiation of care after a concussion
may be warranted to expedite recovery time. This cross-sectional study investigates
the association of the time from a sports injury to the initiation of clinical care
with recovery time after concussion in adolescents and young adults. Recovery after
concussion varies, with adolescents taking longer (approximately 30 days) than adults.
Many factors have been reported to influence recovery, including preinjury factors,
perceptions about recovery, comorbid conditions, and sex. However, 1 factor that may
play a role in recovery but has received little attention from researchers is the
timeliness of clinical evaluation and care. To investigate the association of time
since injury with initiation of clinical care on recovery time following concussion.
This retrospective, cross-sectional study was conducted in a sports medicine clinic
between August 2016 and March 2018. Eligible participants were aged 12 to 22 years
and had a diagnosed, symptomatic concussion; patients were excluded if recovery data
were incomplete. Participants were divided into 2 groups: those seen within 7 days
of the injury (early) vs between 8 and 20 days of the injury (late). Data were analyzed
between June 2019 and August 2019. Time from injury (concussion) to initiation of
clinical care. Recovery time; testing with the Post-Concussion Symptom Scale, Immediate
Post-Concussion Assessment and Cognitive Testing, and Vestibular/Ocular Motor Screening
instruments; demographic factors, medical history, and injury information. A total
of 416 individuals were eligible, and 254 (61.1%) were excluded, leaving 162 (38.9%)
in analyses. The early group (98 patients) and late group (64 patients) did not differ
in age (mean [SD] age, early, 15.3 [1.6] years; late, 15.4 [1.6] years), number of
female patients (early, 51 of 98 [52.0%]; late, 40 of 64 [62.5%]), or other demographic,
medical history, or injury information. The groups also were similar on symptom severity,
cognitive, ocular, and vestibular outcomes at the first clinic visit. Results from
a logistical regression supported being in the late group (adjusted odds ratio, 5.8
[95% CI, 1.9-17.6]; P = .001) and visual motion sensitivity symptoms greater than
2 (adjusted odds ratio, 4.5 [95% CI, 1.1-18.0]; P = .04) as factors significantly
associated with recovery time. Findings suggest that earlier initiation of clinical
care is associated with faster recovery after concussion. Other factors may also influence
recovery time. Further research is needed to determine the role of active rehabilitation
and treatment strategies, as well as demographic factors, medical history, and injury
characteristics on the current findings.