Prior Concussion History and Clinical Recovery Following Sport-Related Concussion in College Athletes

Abstract

Objective: The aim of this study was to assess whether a history of prior concussions, and especially multiple prior concussions, is associated with clinical recovery following a subsequent sport-related concussion among collegiate student athletes. Design: A naturalistic observational cohort study. Setting: Eleven National Collegiate Athletics Association Division III colleges. Participants: Collegiate athletes sustaining concussions from September 2014 through March 2020. Independent Variables: Participants were divided into 3 groups, athletes with: (1) no prior concussion history, (2) one prior concussion, and (3) 2 or more prior concussions. Main Outcome Measures: Survival analyses were used to compare time to return to school and sports among athletes with a history of 0, 1, or ≥2 prior concussions. Results: Among the 1132 college athletes, there were no statistically significant group differences between those with 0, 1, or ≥2 prior concussions in total time to return to school or sports. There was a statistically significant difference in the proportion of athletes with ≥2 prior concussions that had not fully returned to school, without accommodations, at 28 days (6.0%) compared to athletes with no prior concussions (2.2%; odds ratio = 2.80, 95% confidence interval 1.29-6.04). Conclusions: In summary, concussion history was not associated with time to return to sports following a subsequent sport-related concussion in these college athletes. On average, athletes with prior concussions did not take longer to return to school, although a slightly greater proportion of college athletes with ≥2 prior concussions had not fully returned to school, without accommodations, by 28 days following injury.