@article{ref1,
title="The influence of timing of reporting and clinic presentation on concussion recovery outcomes: a systematic review and meta-analysis",
journal="Sports medicine",
year="2021",
author="Barnhart, Mitchell and Bay, R. Curtis and Valovich McLeod, Tamara C.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Identifying risk factors for prolonged recovery following concussion can assist clinicians with appropriate management strategies. It is thought that athletes who continue to participate following a hit to the head or body may take longer to recover following a concussion diagnosis. <br><br>OBJECTIVE: To systematically review the body of literature regarding the effect of delayed reporting and delayed presentation to medical providers on concussion recovery times. <br><br>DESIGN: Systematic review with meta-analysis. DATA SOURCES: PubMed, Ovid Medline, SPORTDiscus, Cochrane Central Register of Controlled Trials and hand searches of reference lists. All the searches were performed in April 2020. ELIGIBILITY CRITERIA FOR SELECTED STUDIES: Studies included an investigation of immediate versus delayed reporting or early versus late presentation following a concussion, were published in the past ten years, and were level 4 evidence or higher. <br><br>RESULTS: 12 studies were included. Patients who continued play or delayed reporting their concussion had significantly longer recovery times (standardized mean difference = 0.36 days (95%CI 0.066, 0.662) than those who immediately reported or were removed from play (p = 0.017). Expressed in raw scores, those who immediately reported recovered in 5.4 days (95% CI - 10.14, - 0.75) fewer than delayed reporters. Comparable results were found for post-concussion symptom scores (p = 0.034) with immediate reporters demonstrating lower symptom severity scores. Our qualitative synthesis found patients who presented earlier to a concussion specialist tended to recover faster than those who presented later. <br><br>CONCLUSIONS: Patients who delayed reporting or continued play had longer recovery times compared to their immediately-reporting peers. Providers should ask concussion patients approximately how long they waited to report their injury, and also focus educational efforts on encouraging immediate reporting of concussion.<p /> <p>Language: en</p>",
language="en",
issn="0112-1642",
doi="10.1007/s40279-021-01444-7",
url="http://dx.doi.org/10.1007/s40279-021-01444-7"
}