@article{ref1,
title="Optimizing concussion care seeking: a longitudinal analysis of recovery",
journal="American journal of sports medicine",
year="2022",
author="Schmidt, Julianne D. and Broglio, Steven P. and Knight, Kristen and Leeds, Daniel and Lynall, Robert C. and D'Lauro, Christopher and Register-Mihalik, Johna and Kroshus, Emily and McCrea, Michael and McAllister, Tom W. and Kerr, Zachary Y. and Hoy, April and Kelly, Louise and Master, Christina and Ortega, Justus and Port, Nicholas and Campbell, Col Darren USAF [retired and Svoboda, Col Steven J. USA [retired and Putukian, Margot and Chrisman, Sara P. D. and Langford, Dianne and McGinty, Gerald and Jackson, Jonathan C. and Cameron, Kenneth L. and James Susmarski, Adam and Difiori, John and Goldman, Joshua T. and Benjamin, Holly and Buckley, Thomas and Kaminski, Thomas and Clugston, James R. and O'Donnell, Patrick G. and Feigenbaum, Luis and Eckner, James T. and Mihalik, Jason P. and Anderson, Scott and Kontos, Anthony and Brooks, M. Alison and Miles, Christopher and Lintner, Laura",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Approximately half of concussions go undisclosed and therefore undiagnosed. Among diagnosed concussions, 51% to 64% receive delayed medical care. Understanding the influence of undiagnosed concussions and delayed medical care would inform medical and education practices. <br><br>PURPOSE: To compare postconcussion longitudinal clinical outcomes among (1) individuals with no concussion history, all previous concussions diagnosed, and ≥1 previous concussion undiagnosed, as well as (2) those who have delayed versus immediate symptom onset, symptom reporting, and removal from activity after concussion. STUDY DESIGN: Cohort study; Level of evidence, 2. <br><br>METHODS: Participants included 2758 military academy cadets and intercollegiate athletes diagnosed with concussion in the CARE Consortium. We determined (1) each participant's previous concussion diagnosis status self-reported at baseline (no history, all diagnosed, ≥1 undiagnosed) and (2) whether the participant had delayed or immediate symptom onset, symptom reporting, and removal from activity. We compared symptom severities, cognition, balance, and recovery duration at baseline, 24 to 48 hours, date of asymptomatic status, and date of unrestricted return to activity using tests of parallel profiles. <br><br>RESULTS: The ≥1 undiagnosed concussion group had higher baseline symptom burdens (P <.001) than the other 2 groups and poorer baseline verbal memory performance (P =.001) than the all diagnosed group; however, they became asymptomatic and returned to activity sooner than those with no history. Cadets/athletes who delayed symptom reporting had higher symptom burdens 24 to 48 hours after injury (mean ± SE; delayed, 28.8 ± 0.8; immediate, 20.6 ± 0.7), took a median difference of 2 days longer to become asymptomatic, and took 3 days longer to return to activity than those who had immediate symptom reporting. For every 30 minutes of continued participation after injury, days to asymptomatic status increased 8.1% (95% CI, 0.3%-16.4%). <br><br>CONCLUSION: Clinicians should expect that cadets/athletes who delay reporting concussion symptoms will have acutely higher symptom burdens and take 2 days longer to become asymptomatic. Educational messaging should emphasize the clinical benefits of seeking immediate care for concussion-like symptoms.<p /> <p>Language: en</p>",
language="en",
issn="0363-5465",
doi="10.1177/03635465221135771",
url="http://dx.doi.org/10.1177/03635465221135771"
}