In the Journals

Concussion recovery twice as long if athlete not immediately removed

Concussion recovery times were twice as long if the athlete was not immediately removed from play, according to recent findings published in Pediatrics.

“Athletes who continued to play with a [sports-related concussion] required nearly twice as long to recover than those who were immediately removed from play (44 vs. 22 days),” R.J. Elbin, PhD, in the department of human health at the Office for Sports Concussion Research at University of Arkansas, and colleagues wrote. “These athletes demonstrated worse postinjury neurocognitive and symptom presentation at 1 to 7 days and at 8 to 30 days than athletes immediately removed from play.”

Clinical guidelines recommend immediate removal from play if an athlete is suspected to have a concussion, the researchers wrote. However, an estimated 50% to 70% of concussions go unreported or undetected, and the effects of continuing to play with a concussion are unknown in adolescent athletes.

Elbin and colleagues compared neurocognitive performance, symptoms and recovery time between 35 athletes (mean age, 15.61 years) immediately removed after experiencing a concussion and 34 athletes (mean age, 15.35 years) who continued to play. The researchers obtained neurocognitive and symptom data at baseline, at 1 to 7 days and at 8 to 30 days after concussion.

The researchers found that those who continued to play took longer to recover than those who did not (44.4 vs. 22 days; P = .003) and were 8.8 times more likely to demonstrate protracted recovery after 21 days (P < .001). Compared with other factors, removal from play status was associated with highest risk for protracted recovery (aOR = 14.27; P = .001). In addition, those who continued to play had significantly worse neurocognitive symptoms.

The researchers concluded that concussion recovery time may be reduced if athletes are removed from play.

“Despite increases in awareness, athletes continue to play with [sports-related concussions] with fear of being removed from participation,” the researchers wrote. “These findings should be incorporated into [sports-related concussion] education and awareness programs for athletes, coaches, parents and medical professionals.” – by Will Offit

Disclosure: One researcher reports being a founder and board member of ImPACT Applications, Inc. Another researcher reports being a member of the scientific advisory board for ImPACT Applications, Inc.