Sex, race, ADHD, and prior concussions as predictors of concussion recovery in adolescents

Objective: Concussions in adolescents are a growing public health concern as the popularity of high school sports increases. The aim of this study was to identify clinical (e.g., prior concussion, migraine history, learning disabilities/attention deficit hyperactivity disorders [ADHD]) and demographic factors (e.g., sex, race, health insurance, mechanism of injury/sport, education) that predict concussion recovery times. Design: In a retrospective cohort study of adolescents 13-19 years old evaluated for an acute concussion (<= 10 days from injury), recovery times were calculated from the date of concussive injury to the date of clearance to return to play or normal activities. Results: The sample (N = 227) was primarily male (75%), and the median age was 15 years. Predictors of protracted recovery were ADHD (hazard ratio [HR] =.449, 95% confidence interval [CI] =.272-.741, p = .002) and prior concussion (HR =.574, 95% CI =.397-.828, p = .003) in all sex and race groups, while shorter recovery times were predicted by Hispanic and African American race (HR = 2.12, 95% CI = 1.30-3.46, p = .003), with White females as the reference group. Conclusions: Further research is needed to examine the role of sex, race, ADHD, and concussion history on concussion outcomes.