Average symptom severity and related predictors of prolonged recovery in pediatric patients with concussion

The purpose of this study is to compare the predictive utility of total number of individual symptoms endorsed, total symptom severity, and average symptom severity on prolonged recovery among children/adolescents with a concussion. Patients (n = 115) completed the Post-Concussion Symptom Scale (PCSS) at their initial clinical visit (7.9 ± 6.6 days) days post-injury. PCSS outcomes were total symptom severity (i.e., total PCSS score), number of symptoms endorsed (i.e., number out of 22-items on the PCSS with a symptom score >0) and average symptom severity (i.e., mean of scores for each of the 22-items on the PCSS, not just endorsed symptoms). Logistic regression was performed with all symptom measures and recovery time >30 days as the binary outcome. Logistic regression indicated that average symptom severity (OR = 1.9; p = 0.01) and later time to first clinical visit (OR = 5.0; p < 0.001) were the only significant predictors of recovery time. Average symptom severity at initial clinic visit and earlier clinical visit may be a better predictor of recovery time than total number of symptoms endorsed or total symptom severity among children and adolescents.