TY  - JOUR
PY  - 2022//
TI  - Optimizing concussion care seeking: the influence of previous concussion diagnosis status on baseline assessment outcomes
JO  - American journal of sports medicine
A1  - Lynall, Robert C.
A1  - D'Lauro, Christopher
A1  - Kerr, Zachary Y.
A1  - Knight, Kristen
A1  - Kroshus, Emily
A1  - Leeds, Daniel D.
A1  - Register-Mihalik, Johna K.
A1  - McCrea, Michael
A1  - Broglio, Steven P.
A1  - McAllister, Thomas
A1  - Schmidt, Julianne D.
A1  - Hazzard, Joseph Jr
A1  - Kelly, Louise
A1  - Master, Christina
A1  - Ortega, Justus
A1  - Port, Nicholas
A1  - Campbell, Darren
A1  - Svoboda, Steven J.
A1  - Putukian, Margot
A1  - Chrisman, Sara P. D.
A1  - Clugston, James R.
A1  - Langford, Dianne
A1  - McGinty, Gerald
A1  - Cameron, Kenneth L.
A1  - Houston, Megan N.
A1  - Susmarski, Adam James
A1  - Goldman, Joshua T.
A1  - Giza, Christopher
A1  - Benjamin, Holly
A1  - Buckley, Thomas
A1  - Kaminski, Thomas
A1  - Feigenbaum, Luis
A1  - Eckner, James T.
A1  - Mihalik, Jason P.
A1  - Anderson, Scott
A1  - McDevitt, Jane
A1  - Kontos, Anthony
A1  - Brooks, M. Alison
A1  - Rowson, Steve
A1  - Miles, Christopher
A1  - Lintner, Laura
A1  - O'Donnell, Patrick G.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: The prevalence of unreported concussions is high, and undiagnosed concussions can lead to worse postconcussion outcomes. It is not clear how those with a history of undiagnosed concussion perform on subsequent standard concussion baseline assessments. <br><br>PURPOSE: To determine if previous concussion diagnosis status was associated with outcomes on the standard baseline concussion assessment battery. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. <br><br>METHODS: Concussion Assessment, Research, and Education (CARE) Consortium participants (N = 29,934) self-reported concussion history with diagnosis status and completed standard baseline concussion assessments, including assessments for symptoms, mental status, balance, and neurocognition. Multiple linear regression models were used to estimate mean differences and 95% CIs among concussion history groups (no concussion history [n = 23,037; 77.0%], all previous concussions diagnosed [n = 5315; 17.8%], ≥1 previous concussions undiagnosed [n = 1582; 5.3%]) at baseline for all outcomes except symptom severity and Brief Symptom Inventory-18 (BSI-18) score, in which negative binomial models were used to calculate incidence rate ratios (IRRs). All models were adjusted for sex, race, ethnicity, sport contact level, and concussion count. Mean differences with 95% CIs excluding 0.00 and at least a small effect size (≥0.20), and those IRRs with 95% CIs excluding 1.00 and at least a small association (IRR, ≥1.10) were considered significant. <br><br>RESULTS: The ≥1 previous concussions undiagnosed group reported significantly greater symptom severity scores (IRR, ≥1.38) and BSI-18 (IRR, ≥1.31) scores relative to the no concussion history and all previous concussions diagnosed groups. The ≥1 previous concussions undiagnosed group performed significantly worse on 6 neurocognitive assessments while performing better on only 2 compared with the no concussion history and all previous concussions diagnosed groups. There were no between-group differences on mental status or balance assessments. <br><br>CONCLUSION: An undiagnosed concussion history was associated with worse clinical indicators at future baseline assessments. Individuals reporting ≥1 previous undiagnosed concussions exhibited worse baseline clinical indicators. This may suggest that concussion-related harm may be exacerbated when injuries are not diagnosed.<p />  <p>Language: en</p>
LA  - en
SN  - 0363-5465
UR  - http://dx.doi.org/10.1177/03635465221118089
ID  - ref1
ER  -