Social Demographic and Clinical Predictors of Time to Clinic Presentation After a Sport-Related Concussion

Objective:To investigate the associations between clinical risk factors, social demographic and time to concussion clinic presentation after sports-related concussion in young athletes. Design:Retrospective cohort study. Setting:Multidisciplinary regional concussion center. Patients:Athletes ages 12 to 18 years who sustained a SRC from November 2017 to April 2022. Independent Variables:Independent variables included social demographic factors (ie, race, ethnicity, public vs private school, public vs private insurance), patient medical history, family medical history, acute concussion characteristics, and initial presentation elsewhere. Main Outcome Measures:Descriptive statistics were employed to assess for group differences. Mann-Whitney U tests, Spearman rank order correlations, and linear regressions were performed to explore associations between each independent variable and the main outcome, days to concussion clinic presentation. Results:A total of 945 athletes we included (age 15.8 +/- 1.61, 33.7% female). Hispanic/Latino background, (P = 0.009), public insurance status (U = 47 377.0, P = 0.002), amnesia (U = 57 738.0, P = 0.002) at time of injury, family psychiatric (U = 35 091.0, P < 0.001) or migraine (U = 59 594.5, P < 0.001) histories, and personal psychiatric (U = 30 798.0, P = 0.004) or migraine (U = 34 133.5, P = 0.011) histories were associated with longer time to concussion clinic presentation. A multivariable linear regression found that initial presentation elsewhere (beta = 0.37, P < 0.001), family migraine history (beta = 0.18, P < 0.001), public insurance status (beta = 0.09, P = 0.024), and history of learning disability (beta = 0.09, P = 0.032) were the only predictors of longer time to concussion clinic presentation. Conclusions:Variables that predicted longer time to concussion clinic presentation included initial presentation elsewhere, public insurance status, positive family migraine history, and history of learning disability. Further research is needed to elucidate these findings and determine how they impact concussion seeking behavior.