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Abstract
Identifying vulnerability factors for developing persisting concussion symptoms is imperative for determining which patients may require specialized treatment. Using cross-sectional questionnaire data from an Ontario-wide observational concussion study, we compared patients with acute concussion (≤ 14 days) and prolonged post-concussion symptoms (PPCS) (≥ 90 days) on four factors of interest: sex, history of mental health disorders, history of headaches/migraines, and past concussions. Differences in profile between the two groups were also explored. 110 patients with acute concussion and 96 patients with PPCS were included in our study. The groups did not differ on the four factors of interest. Interestingly, both groups had greater proportions of females (acute concussion: 61.1% F; PPCS: 66.3% F). Patient profiles, however, differed wherein patients with PPCS were significantly older, more symptomatic, more likely to have been injured in a transportation-related incident, and more likely to live outside a Metropolitan city. These novel risk factors for persisting concussion symptoms require replication and highlight the need to re-evaluate previously identified risk factors as more and more concussions occur in non-athletes and different risk factors may be at play.
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1 University Health Network, Canadian Concussion Centre, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428)
2 Hamilton Health Sciences, Hamilton, Canada (GRID:grid.413615.4) (ISNI:0000 0004 0408 1354)
3 Lakehead University, EPID@Work Research Institute, Thunder Bay, Canada (GRID:grid.258900.6) (ISNI:0000 0001 0687 7127)
4 St. Michael’s Hospital, Head Injury Clinic, Department of Trauma and Neurosurgery, Toronto, Canada (GRID:grid.415502.7); University of Toronto, Dalla Lana School of Public Health, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938); Concussion Ontario Network: Neuroinformatics to Enhance Clinical Care and Translation, Toronto, Canada (GRID:grid.17063.33)
5 Lakehead University, EPID@Work Research Institute, Thunder Bay, Canada (GRID:grid.258900.6) (ISNI:0000 0001 0687 7127); Lakehead University, Department of Health Sciences, Thunder Bay, Canada (GRID:grid.258900.6) (ISNI:0000 0001 0687 7127)
6 University Health Network, Neurotrauma Care Pathways Project, KITE Research Institute, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428)
7 University Health Network, Hull-Ellis Concussion Clinic, Toronto Rehabilitation Institute, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428)
8 Northern Ontario School of Medicine University, Thunder Bay, Canada (GRID:grid.436533.4) (ISNI:0000 0000 8658 0974); Health Sciences North Research Institute, Sudbury, Canada (GRID:grid.420638.b) (ISNI:0000 0000 9741 4533)
9 Parachute, Toronto, Canada (GRID:grid.497643.b) (ISNI:0000 0004 0378 5317)
10 University of Toronto, Neuropsychiatry Program, Division of Neurology, Department of Psychiatry, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938); Sunnybrook Research Institute, Hurvitz Brain Sciences Research Program, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0004 0469 1398)
11 University of Toronto, Department of Physical Therapy, Temerty Faculty of Medicine, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938); University Health Network, KITE Research Institute, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428)
12 St. Michael’s Hospital, Head Injury Clinic, Department of Trauma and Neurosurgery, Toronto, Canada (GRID:grid.415502.7)
13 Unity Health Toronto, Brain Health and Wellness Research Program, St. Michael’s Hospital, Toronto, Canada (GRID:grid.415502.7); University of Toronto, Faculty of Medicine, Institute of Medical Science, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938); University of Toronto, Department of Anesthesia, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938)
14 University Health Network, Hull-Ellis Concussion Clinic, Toronto Rehabilitation Institute, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428); University of Toronto, Division of Physical Medicine and Rehabilitation, Temerty Medicine, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938)
15 St. Michael’s Hospital, MAP Centre for Urban Health Solutions, Toronto, Canada (GRID:grid.415502.7)
16 Ontario Brain Injury Association, St. Catherines, Canada (GRID:grid.415502.7)
17 University of Toronto, Dalla Lana School of Public Health, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938)
18 University of Toronto, Dalla Lana School of Public Health, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938); St. Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada (GRID:grid.415502.7); University of Toronto, Division of Neurosurgery, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938)
19 Ottawa Hospital Research Institute, Ottawa, Canada (GRID:grid.17063.33) (ISNI:0000 0004 0500 0659); University of Ottawa, Department of Medicine, Ottawa, Canada (GRID:grid.28046.38) (ISNI:0000 0001 2182 2255)
20 University Health Network, Toronto Rehabilitation Institute, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428); University of Toronto, Department of Rehabilitation Sciences, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938)
21 University of Ottawa, School of Human Kinetics, Ottawa, Canada (GRID:grid.28046.38) (ISNI:0000 0001 2182 2255)
22 The Hospital for Sick Children, Department of Critical Care, Toronto, Canada (GRID:grid.430185.b); The Hospital for Sick Children Research Institute, Neuroscience and Mental Health Research Program, Toronto, Canada (GRID:grid.430185.b); University of Toronto, Interdepartmental Division of Critical Care, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938); University of Toronto, Department of Paediatrics, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938)
23 University of Toronto, Faculty of Medicine (Neurosurgery), Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938); St. Michael’s Hospital, Neuroscience Research Program, Toronto, Canada (GRID:grid.415502.7); St Michael’s Hospital, Keenan Research Centre, Toronto, Canada (GRID:grid.415502.7)
24 University of Toronto, Faculty of Kinesiology and Physical Education, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938); University of Toronto, MacIntosh Sport Medicine Clinic, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938)
25 Concussion Ontario Network: Neuroinformatics to Enhance Clinical Care and Translation, Toronto, Canada (GRID:grid.17063.33)
26 St. Michael’s Hospital, Trauma and Neurosurgery Program, Toronto, Canada (GRID:grid.415502.7)
27 University Health Network, Canadian Concussion Centre, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428); University Health Network, Division of Neurology, Toronto Western Hospital, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428); University of Toronto, Tanz Centre for Research in Neurodegenerative Diseases, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938)