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Medline ® Abstract for Reference 30

of 'Sideline evaluation of concussion'

Sport-related concussion: factors associated with prolonged return to play.
Asplund CA, McKeag DB, Olsen CH
Clin J Sport Med. 2004;14(6):339.
OBJECTIVE: To assess predictive value of concussion signs and symptoms based on return-to-play timelines.
DESIGN: Physician practice study without diagnosis that includes presentation, initial and subsequent treatment, and management of concussion.
SETTING: National multisite primary care sports medicine provider locations.
PARTICIPANTS: Twenty-two providers at 18 sites; 101 athletes (91 men, 10 women in the following sports: 73 football, 8 basketball, 8 soccer, 3 wrestling, 2 lacrosse, 2 skiing, 5 others; 51 college, 44 high school, 4 professional, and 2 recreational).
MAIN OUTCOME MEASUREMENTS: Duration of symptoms, presence of clinical signs, and time to return to play following concussion.
RESULTS: One hundred one concussions were analyzed. Pearson chi2 analysis of common early and late concussion symptoms revealed statistical significance (P<0.05) of headache>3 hours, difficulty concentrating>3 hours, any retrograde amnesia or loss of consciousness, and return to play>7 days. There appeared to be a trend in patients with posttraumatic amnesia toward poor outcome, but this was not statistically significant.
CONCLUSIONS: When evaluating concussion, symptoms of headache>3 hours, difficulty concentrating>3 hours, retrograde amnesia, or loss of consciousness may indicate a more severe injury or prolonged recovery; great caution should be exercised before returning these athletes to play.
Department of Family Practice, DeWitt Army Community Hospital, Fort Belvoir, VA 22060, USA. chad.asplund@us.army.mil