Factors Influencing Time to Return to Learn Among NCAA Student-Athletes Enrolled in the Concussion Assessment, Research, and Education (CARE) Study

期刊论文
发表日期：

2024年2月26日

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Allyssa K. Memmini,
Traci R. Snedden,
Adrian J. Boltz,
Benjamin A. Benson,
Eric Margolin,
Paul F. Pasquina,
Thomas W. McAllister,
Michael A. McCrea,
Steven P. Broglio,
April Hoy,
Louise Kelly,
Justus Ortega,
Jessica Miles,
Nicholas Port,
Sara Chrisman,
Dianne Langford,
Jane McDevitt,
Christina Master,
Patrick O’Donnell,
Christopher D’Lauro,
Gerald McGinty,
Kenneth Cameron,
Adam Susmarski,
Joshua Goldman,
Holly Benjamin,
Thomas Buckley,
Thomas Kaminski,
James Clugston,
Luis Feigenbaum,
James Eckner,
Jason Mihalik,
Anthony Kontos,
Alison Brooks,
Steven Rowson,
Laura Lintner,
Christopher Miles,
Jody Harl,
Janetta Matesan,
Michael Menser,
Ashley Rettmann,
Nicole L’Heureux,
Melissa McEachern,
Michael Jarrett,
Vibeke Brinck,
Bianca Byrne,
Melissa Baker,
Christy Collins,
Will Felix,
Bethany Morath

摘要

Purpose

The aim was to describe the demographic and post-injury factors that influence time to return to learn (RTL) among student-athletes enrolled in the Concussion Assessment, Research and Education (CARE) Consortium.

Methods

A total of 47,860 student-athletes enrolled in the National Collegiate Athletic Association-Department of Defense (NCAA-DoD) CARE Consortium study from 2014 to 2020, with 1485 sport-related concussions (SRCs) analyzed in the present dataset. Demographic and post-injury characteristics were calculated using descriptive statistics, followed by Kaplan–Meier estimates to examine median time to return to normal academic performance (i.e., RTL) by sex (male, female), baseline psychiatric conditions (depression, anxiety) and/or learning disorder, NCAA division (I, II, III), SRC history (0, 1, 2, 3+), NCAA sport category (contact, limited contact, non-contact sport), and median difference in baseline/post-injury symptom severity scores (< 21, ≥ 21). Further, a multivariable zero-inflated negative binomial (ZINB) regression model was used to examine their association with RTL.

Results

Overall, time to RTL (mean = 4.96 ± 8.24 days, median = 3.0 [interquartile range = 0.0, 6.0] days) was found to be influenced by several factors resulting in earlier trajectories. Notably, nearly 25% of the sample demonstrated immediate RTL (i.e., 0 days). Among student-athletes who did not immediately RTL, males demonstrated a decreased rate in RTL (rate = 0.79; 95% CI 0.66–0.96) compared to females. Further, student-athletes with a ≥ 21 change in symptom severity score (post-injury baseline) demonstrated a higher rate of RTL (rate = 1.47; 95% CI 1.21–1.79) compared to student-athletes with a symptom severity change score < 21. Lastly, male student-athletes demonstrated two times higher odds (odds ratio = 1.95; 95% CI 1.02–3.73) of immediate RTL compared to female student-athletes. No other covariates were associated with time to RTL.

Conclusion

Collectively, the present findings suggest a rapid return to the classroom following concussion. Specifically, males demonstrated higher odds of time to RTL, whereas those with greater differences in symptom severity resulted in a higher rate of time to RTL among those who did not immediately RTL. Ultimately, these findings support prior work emphasizing an individualized approach to SRC management.