Browsing by Author "Chrisman, Sara P. D."

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    King-Devick testing and concussion recovery time in collegiate athletes
    (Elsevier, 2022) Whelan, Bridget M.; Gause, Emma L.; Ortega, Justus D.; Mills, Brianna M.; Schmidt, Julianne D.; Kaminski, Thomas W.; Buckley, Thomas A.; Breedlove, Katherine M.; Kontos, Anthony P.; Clugston, James R.; Goldman, Joshua T.; Harmon, Kimberly G.; McCrea, Michael A.; McAllister, Thomas W.; Broglio, Steven P.; Chrisman, Sara P. D.; Psychiatry, School of Medicine
    Objectives: To assess whether the King-Devick (KD) test is useful as a prognostic test for prolonged concussion symptoms by examining the relationship between a) change in performance on KD test from baseline to within two days post-injury and b) the absolute KD time at post-concussion testing, with an outcome of time to return to play (RTP). Design: Prospective Cohort Study. Methods: Collegiate varsity athletes in the Concussion Assessment, Research, and Education (CARE) Consortium completed baseline and post-injury King-Devick tests from 2014 to 2018. Two exposures were evaluated: 1) change in KD score from baseline to within two days post-injury and 2) absolute KD score within two days post-injury, adjusted for baseline KD. We used Cox proportional hazards models to analyze the relationships between these exposures and time to RTP post-concussion. Results: A total of 309 concussion injuries were included. Median baseline KD score was 40.0 s (IQR: 35.8, 45.2). Median post-injury KD score was 45.8 s (IQR: 39.8, 57.1). Median number of days until RTP in this cohort was 11 (IQR: 8, 17). Post-injury KD score adjusted for baseline KD had a stronger association with time to RTP duration (HR: 0.99 (0.98, 1.00), p = 0.03) than the difference in KD score from baseline to post-injury (HR: 0.99 (0.99, 1.00), p = 0.07). Conclusions: Higher post-injury KD scores are associated with longer RTP. The association between KD post-concussion test and longer RTP warrants further investigation to assess the utility of the KD for prognostication in a clinical setting.
  • Thumbnail Image
    Item
    Mechanisms of Injury Leading to Concussions in Collegiate Soccer Players: A CARE Consortium Study
    (Sage, 2024) Jo, Jacob; Boltz, Adrian J.; Williams, Kristen L.; Pasquina, Paul F.; McAllister, Thomas W.; McCrea, Michael A.; Broglio, Steven P.; Zuckerman, Scott L.; Terry, Douglas P.; CARE Consortium Investigators; Arbogast, Kristy; Benjamin, Holly J.; Brooks, Alison; Cameron, Kenneth L.; Chrisman, Sara P. D.; Clugston, James R.; Collins, Micky; DiFiori, John; Eckner, James T.; Estevez, Carlos; Feigenbaum, Luis A.; Goldman, Joshua T.; Hoy, April; Kaminski, Thomas W.; Kelly, Louise A.; Kontos, Anthony P.; Langford, Dianne; Lintner, Laura J.; Master, Christina L.; McDevitt, Jane; McGinty, Gerald; Miles, Chris; Ortega, Justus; Port, Nicholas; Rowson, Steve; Schmidt, Julianne; Susmarski, Adam; Svoboda, Steven; Psychiatry, School of Medicine
    Background: Few previous studies have investigated how different injury mechanisms leading to sport-related concussion (SRC) in soccer may affect outcomes. Purpose: To describe injury mechanisms and evaluate injury mechanisms as predictors of symptom severity, return to play (RTP) initiation, and unrestricted RTP (URTP) in a cohort of collegiate soccer players. Study design: Cohort study; Level of evidence, 2. Methods: The Concussion Assessment, Research and Education (CARE) Consortium database was used. The mechanism of injury was categorized into head-to-ball, head-to-head, head-to-body, and head-to-ground/equipment. Baseline/acute injury characteristics-including Sports Concussion Assessment Tool-3 total symptom severity (TSS), loss of consciousness (LOC), and altered mental status (AMS); descriptive data; and recovery (RTP and URTP)-were compared. Multivariable regression and Weibull models were used to assess the predictive value of the mechanism of injury on TSS and RTP/URTP, respectively. Results: Among 391 soccer SRCs, 32.7% were attributed to a head-to-ball mechanism, 27.9% to a head-to-body mechanism, 21.7% to a head-to-head mechanism, and 17.6% to a head-to-ground/equipment mechanism. Event type was significantly associated with injury mechanism [χ2(3) = 63; P < .001), such that more head-to-ball concussions occurred in practice sessions (n = 92 [51.1%] vs n = 36 [17.1%]) and more head-to-head (n = 65 [30.8%] vs n = 20 [11.1]) and head-to-body (n = 76 [36%] vs n = 33 [18.3%]) concussions occurred in competition. The primary position was significantly associated with injury mechanism [χ2(3) = 24; P < .004], with goalkeepers having no SRCs from the head-to-head mechanism (n = 0 [0%]) and forward players having the least head-to-body mechanism (n = 15 [19.2%]). LOC was also associated with injury mechanism (P = .034), with LOC being most prevalent in head-to-ground/equipment. Finally, AMS was most prevalent in head-to-ball (n = 54 [34.2%]) and head-to-body (n = 48 [30.4%]) mechanisms [χ2(3) = 9; P = .029]. In our multivariable models, the mechanism was not a predictor of TSS or RTP; however, it was associated with URTP (P = .044), with head-to-equipment/ground injuries resulting in the shortest mean number of days (14 ± 9.1 days) to URTP and the head-to-ball mechanism the longest (18.6 ± 21.6 days). Conclusion: The mechanism of injury differed by event type and primary position, and LOC and AMS were different across mechanisms. Even though the mechanism of injury was not a significant predictor of acute symptom burden or time until RTP initiation, those with head-to-equipment/ground injuries spent the shortest time until URTP, and those with head-to-ball injuries had the longest time until URTP.
  • Thumbnail Image
    Item
    Postinjury Outcomes After Non-Sport-Related Concussion: A CARE Consortium Study
    (Allen Press, 2024) Roby, Patricia R.; Mozel, Anne E.; Arbogast, Kristy B.; Buckley, Thomas; Caccese, Jaclyn B.; Chrisman, Sara P. D.; Clugston, James R.; Eckner, James T.; Esopenko, Carrie; Hunt, Tamerah; Kelly, Louise A.; McDevitt, Jane; Perkins, Susan M.; Putukian, Margot; Susmarski, Adam; Broglio, Steven P.; Pasquina, Paul F.; McAllister, Thomas W.; McCrea, Michael; Master, Christina L.; CARE Consortium Investigators; Psychiatry, School of Medicine
    Context: Concussion research has primarily focused on sport-related mechanisms and excluded non-sport-related mechanisms. In adult populations, non-sport-related concussions (non-SRCs) demonstrated worse clinical outcomes compared with sport-related concussions (SRCs); however, investigations of non-SRCs in college-aged patients are limited. Objectives: To examine clinical outcomes in collegiate athletes with non-SRCs compared with SRCs and explore sex differences in outcomes among collegiate athletes with non-SRCs. Design: Prospective cohort study. Setting: Clinical setting. Patients or other participants: A total of 3500 athletes were included (n = 555 with non-SRCs, 42.5% female) from colleges or universities and service academies participating in the National Collegiate Athletic Association Department of Defense Concussion Assessment, Research and Education (CARE) Consortium. Main outcome measure(s): Dichotomous outcomes (yes or no) consisted of immediate reporting, mental status alterations, loss of consciousness, posttraumatic amnesia, retrograde amnesia, motor impairments, delayed symptom presentation, and required hospital transport. Continuous outcomes were symptom severity, days with concussion symptoms, and days lost to injury. Data were collected within 24 to 48 hours of injury and at return to play. Adjusted relative risks (ARRs) compared the likelihood of dichotomous outcomes by mechanism and by sex within patients with non-SRCs. Multivariate negative binomial regressions were used to assess group differences in continuous variables. Results: Athletes with non-SRCs were less likely to report immediately (ARR = 0.73, 95% CI = 0.65, 0.81) and more likely to report delayed symptom presentation (ARR = 1.17, 95% CI = 1.03, 1.32), loss of consciousness (ARR = 3.15, 95% CI = 2.32, 4.28), retrograde amnesia (ARR = 1.77, 95% CI = 1.22, 2.57), and motor impairment (ARR = 1.45, 95% CI = 1.14, 1.84). Athletes with non-SRCs described greater symptom severity, more symptomatic days, and more days lost to injury (P < .001) compared with those who had SRCs. Within the non-SRC group, female athletes indicated greater symptom severity, more symptomatic days, and more days lost to injury (P < .03) than male athletes. Conclusions: Athletes with non-SRCs had worse postinjury outcomes compared with those who had SRCs, and female athletes with non-SRCs had worse recovery metrics than male athletes. Our findings suggest that further investigation of individuals with non-SRCs is needed to improve concussion reporting and management.