Acute and subacute clinical markers after sport-related concussion in rugby union players

Abstract

Objectives: The purpose of this study was to investigate the relationship between on-field post-concussion symptoms reported by athletes, on-field neurological signs reported by a trainer or physician, and/or post-concussion symptoms 72 h after brain injury in male rugby players. Design: Cross-sectional study in a Sports Concussion Clinic setting. Methods: We enrolled 92 adult rugby union players, within the first 72 h after sport concussion. Four scales were measured. Immediate Concussion Sign Checklist (sideline); Immediate Concussion Symptom Checklist (24 h after concussion); Post-Concussion Symptoms Scale and Beck Depression Inventory (in-office 72 h after concussion). Results: Odds ratios revealed that overtly symptomatic athletes were over 2.6 times more likely (p = 0.047) to exhibit post-traumatic amnesia than asymptomatic athletes. There were no differences in terms of on-field loss of consciousness or confusion. Immediate symptoms reported by athletes retrospectively were associated with symptoms reported on the Beck Depression Inventory (odds ratio 2.8; 95 % confidence interval 1.14–6.88), headache (odds ratio 4.9; 95 % confidence interval 1.92–12.79), memory concerns (odds ratio 3.15; 95 % confidence interval 1.06–9.34), pressure in the head (odds ratio 2.8; 95 % confidence interval 1.03–8.08), and visual disturbances (odds ratio 3.9; 95 % confidence interval 1.05–14.50) reported 72 h after sports concussion. Conclusions: Athletes who were overtly symptomatic after sports concussion were significantly more likely to experience post-traumatic amnesia and two or more on-field concussion signs relative to those athletes who were asymptomatic. Also, players with immediate symptoms reported higher depressive symptoms, somatic symptoms (headache and visual disturbances), and cognitive symptoms.