7.3 Injury setting as a moderator of post-concussive symptom trajectories following pediatric concussion

• Published in: British journal of sports medicine 2024-01, Vol.58 (Suppl 1), p.A34-A34
• Main Authors: Chadwick, Leah, Emery, Carolyn, Madigan, Sheri, Beauchamp, Miriam, Craig, William, Doan, Quynh, Zemek, Roger, Yeates, Keith Owen
• Format: Article
• Language: English
• Subjects: Concussion; First Round Abstract Submissions
• ISSN: 0306-3674; 1473-0480
• DOI: 10.1136/bjsports-2023-concussion.91

ObjectiveTo determine whether differences in post-concussive symptoms (PCS) between children with concussion or orthopedic injuries (OI) are moderated by injury setting (i.e., sport-related versus non-sport-related).Design/Setting/ParticipantsProspective cohort study including children ages 8–16 with concussion (n=529; sport-related=81.9%) or OI (n=264; sport-related=82.3%) recruited in Emergency Departments at five hospitals across Canada.AssessmentPCS were measured using the Health and Behaviour Inventory, a reliable and validated rating scale, at 2 weeks, 3 months, and 6 months post-injury.OutcomesLinear mixed model analyses examined group (concussion vs. OI), injury setting, and time post-injury as predictors of cognitive and somatic PCS.Main ResultsMixed models revealed a significant group by setting by time interaction for cognitive (p =.032), but not somatic symptoms (p =.710). Cognitive symptoms were significantly worse in the concussion group compared to the OI group at 2 weeks post-injury for both sport-related (p < .001, d =.090) and non-sport-related settings (p < .001, d =.495), and for non-sport-related settings at both 3 (p =.020, d =.188) and 6 months (p =.004, d =.236) post-injury, but not for sport-related settings at 3 (p =.138, d =.106) or 6 months (p =.824, d =.018) post-injury. Group differences in cognitive PCS declined over time for both settings, but less rapidly for non-sport-related settings.ConclusionsCognitive PCS appear to be more pronounced and longer lasting when concussions are sustained in non-sport-related settings compared to sport-related settings. This moderating effect was not seen for somatic PCS, suggesting that trajectories of somatic and cognitive PCS are related to different predictors.