Article Document Academic Article Information Content Entity Continuant Continuant Journal Article Entity Entity Generically Dependent Continuant 2025-05-06T21:53:43 RDF description of Identifying the 'miserable minority' among pediatric patients following concussion - http://repository.healthpartners.com/individual/document-rn38271 Brain Pediatrics Journal of Pediatric Surgery Traumatic Brain Injuries 10.1016/j.jpedsurg.2024.162006 Orthopedics 23560 document-rn38271 public <p>OBJECTIVES: To investigate whether there are empirically-detectable subgroups of concussion severity and recovery across three consecutive concussions, as well as to define risk factor and clinical assessment differences across subgroups. METHODS: The present study was a retrospective chart review of 202 adolescents 13.17 ± 1.99 years old who presented to a concussion specialty clinic within 30 days of injury for multiple injuries between 2019 and 2020. Participants included patients from a specialty clinic for two (n = 202) or three (n = 68) total concussions. Latent class analysis (LCA) was used to identify subgroups based upon concussion symptom severity and recovery time. Risk factors (sex, age at first injury, and histories of anxiety, depression, migraine, motion sickness, ocular dysfunction, and attention-deficit/hyperactivity disorder [ADHD] or learning disability [LD]) were compared across subgroups. RESULTS: A two-class solution yielded one group of 163 participants characterized by lower symptoms and shorter recovery times (80.7%, "normal") and 39 participants (19.3%, "miserable minority") characterized by higher symptoms and longer recovery times. Only female sex (OR = 4.91, p = 0.005) was a significant predictor of class membership. The miserable group presented for treatment nearly 4 days later (9.41 days) compared to the normal group (5.74 days) for the first injury, and almost 2 days later for the second injury (7.33 vs 5.26 days). CONCLUSIONS: Approximately 1 in 5 patients who presented to a concussion specialty clinic for a repeat concussion were classified in the miserable minority subgroup. This subgroup was characterized by markedly higher initial symptom burdens and over double the recovery time. LEVEL OF EVIDENCE: Retrospective cohort study, Level III evidence.<p> Sports 2024-12-14T22:07:15.519-06:00 Injuries Identifying the 'miserable minority' among pediatric patients following concussion Retrospective Studies 2 40760 60