TY - JOUR
T1 - Medical Disqualification Following Concussion in Collegiate Student-Athletes
T2 - Findings from the CARE Consortium
AU - CARE Consortium Investigators
AU - Schmidt, Julianne D.
AU - Rawlins, Michelle L.Weber
AU - Lynall, Robert C.
AU - D’Lauro, Christopher
AU - Clugston, James R.
AU - McAllister, Tom W.
AU - McCrea, Michael
AU - Broglio, Steven P.
AU - Hoy, April
AU - Hazzard, Joseph
AU - Kelly, Louise
AU - Master, Christina
AU - Ortega, Justus
AU - Port, Nicholas
AU - Campbell, Darren
AU - Svoboda, Steven J.
AU - Putukian, Margot
AU - Chrisman, Sara P.D.
AU - Langford, Dianne
AU - McGinty, Gerald
AU - Jackson, Jonathan C.
AU - Cameron, Kenneth L.
AU - Houston, Megan N.
AU - Susmarski, Adam James
AU - Goldman, Joshua T.
AU - Giza, Christopher
AU - Benjamin, Holly
AU - Buckley, Thomas
AU - Kaminski, Thomas
AU - Feigenbaum, Luis
AU - Eckner, James T.
AU - Mihalik, Jason P.
AU - Anderson, Scott
AU - Kontos, Anthony
AU - Brooks, M. Alison
AU - Duma, Stefan M.
AU - Rowson, Steve
AU - Miles, Christopher
AU - Lintner, Laura
N1 - Publisher Copyright:
© 2020, Springer Nature Switzerland AG.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Background: The absence of evidence-based guidelines make medical disqualification (MDQ) following concussion one of the most challenging decision-making processes faced by sports medicine professionals. Objective: We aimed to compare premorbid and postmorbid factors between student-athletes that were and were not medically disqualified from sport following a concussion. Methods: Among 1832 student-athletes diagnosed with concussion within the CARE Consortium, 53 (2.9%) were medically disqualified (MDQ +) and 1779 (97.1%) were not medically disqualified (MDQ−). We used contingency tables and descriptive statistics for an initial evaluation of a broad list of premorbid and postmorbid factors. For those factors showing association with MDQ status, we calculated odds ratios and 95% confidence intervals for the odds of being MDQ + in the presence of the identified factor. Results: History of 2 (OR: 3.2, 95% CI 1.5, 6.9) or 3 + (OR: 7.4, 95% CI 3.4, 15.9) previous concussions; 1 + headaches in past 3 months (OR: 1.8, 95% CI 1.0, 3.2); immediate removal from play (OR: 2.4, 95% CI 1.2, 4.9); alcohol (OR: 2.6, 95% CI 1.2, 5.4), tobacco (OR: 3.3, 95% CI 1.1, 9.5), or marijuana use since injury (OR: 5.4, 95% CI 1.5, 19.0); as well as prolonged recovery due to mental health alterations (OR: 5.3, 95% CI 2.0, 14.1) or motivation/malingering (OR: 7.5, 95% CI 3.3, 17.0) increased odds of being MDQ +. The MDQ + group took longer to become asymptomatic relative to the MDQ− group (MDQ + : 23.5 days, 95% CI 15.8, 31.2; MDQ−: 10.6 days, 95% CI 9.5, 11.6; p ' 0.001). Conclusions: MDQ following concussion was relatively rare. We identified three patterns related to MDQ following concussion: (1) concussion and headache history were the only premorbid factors that differed (2) initial concussion presentation was more severe and more immediate in the MDQ + group, and (3) post-concussion recovery outcomes expressed the greatest differences between groups.
AB - Background: The absence of evidence-based guidelines make medical disqualification (MDQ) following concussion one of the most challenging decision-making processes faced by sports medicine professionals. Objective: We aimed to compare premorbid and postmorbid factors between student-athletes that were and were not medically disqualified from sport following a concussion. Methods: Among 1832 student-athletes diagnosed with concussion within the CARE Consortium, 53 (2.9%) were medically disqualified (MDQ +) and 1779 (97.1%) were not medically disqualified (MDQ−). We used contingency tables and descriptive statistics for an initial evaluation of a broad list of premorbid and postmorbid factors. For those factors showing association with MDQ status, we calculated odds ratios and 95% confidence intervals for the odds of being MDQ + in the presence of the identified factor. Results: History of 2 (OR: 3.2, 95% CI 1.5, 6.9) or 3 + (OR: 7.4, 95% CI 3.4, 15.9) previous concussions; 1 + headaches in past 3 months (OR: 1.8, 95% CI 1.0, 3.2); immediate removal from play (OR: 2.4, 95% CI 1.2, 4.9); alcohol (OR: 2.6, 95% CI 1.2, 5.4), tobacco (OR: 3.3, 95% CI 1.1, 9.5), or marijuana use since injury (OR: 5.4, 95% CI 1.5, 19.0); as well as prolonged recovery due to mental health alterations (OR: 5.3, 95% CI 2.0, 14.1) or motivation/malingering (OR: 7.5, 95% CI 3.3, 17.0) increased odds of being MDQ +. The MDQ + group took longer to become asymptomatic relative to the MDQ− group (MDQ + : 23.5 days, 95% CI 15.8, 31.2; MDQ−: 10.6 days, 95% CI 9.5, 11.6; p ' 0.001). Conclusions: MDQ following concussion was relatively rare. We identified three patterns related to MDQ following concussion: (1) concussion and headache history were the only premorbid factors that differed (2) initial concussion presentation was more severe and more immediate in the MDQ + group, and (3) post-concussion recovery outcomes expressed the greatest differences between groups.
UR - http://www.scopus.com/inward/record.url?scp=85086735106&partnerID=8YFLogxK
U2 - 10.1007/s40279-020-01302-y
DO - 10.1007/s40279-020-01302-y
M3 - Article
C2 - 32557231
AN - SCOPUS:85086735106
SN - 0112-1642
VL - 50
SP - 1843
EP - 1855
JO - Sports Medicine
JF - Sports Medicine
IS - 10
ER -