Many studies have identified factors associated with increased symptom burden and prolonged recovery after pediatric and adolescent concussion. Few have systematically examined the effects of prior concussion on these outcomes in patients with concussion due to any mechanism. An improved understanding of the short- and long-term effects of a multiple concussion history will improve counseling and management of this subgroup of patients.

A retrospective review of adolescent and young adult acute concussion patients presenting to the multidisciplinary concussion clinic between 2018 and 2019 was conducted at a single center. Patient demographic data, medical history including prior concussion, initial symptom severity score (SSS), injury mechanisms, and recovery times were collected. Univariate and multivariable analyses were conducted to identify associations of history of prior concussion and patient and injury characteristics with symptom score and recovery time.

A total of 266 patients with an average age of 15.4 years (age range 13–27 years) were included. Prior concussion was reported in 35% of patients. The number of prior concussions per patient was not significantly associated with presenting symptom severity, recovery time, or recovery within 28 days. Male sex and sports-related concussion (SRC) were associated with lower presenting SSS and shorter recovery time on univariate but not multivariable analysis. However, compared to non–sport concussion mechanisms, SRC was associated with 2.3 times higher odds of recovery within 28 days (p = 0.04). A history of psychiatric disorders was associated with higher SSS in univariate analysis and longer recovery time in univariate and multivariable analyses. Multivariable log-linear regression also demonstrated 5 times lower odds of recovery within 28 days for those with a psychiatric history.

The results of this study demonstrated that an increasing number of prior concussions was associated with a trend toward higher presenting SSS after youth acute concussion but did not show a significant association with recovery time or delayed (> 28 days) recovery. Presence of psychiatric history was found to be significantly associated with longer recovery and lower odds of early (≤ 28 days) recovery. Future prospective, long-term, and systematic study is necessary to determine the optimal counseling and management of adolescent and young adult patients with a history of multiple concussions.

许多研究已经确定了与儿童和青少年脑震荡后症状负担增加和恢复时间延长相关的因素。很少有人系统地研究过先前的脑震荡对由于任何机制而导致的脑震荡患者的这些结果的影响。更好地了解多次脑震荡病史的短期和长期影响将改善对该亚组患者的咨询和管理。

在单一中心对 2018 年至 2019 年间到多学科脑震荡诊所就诊的青少年和年轻成人急性脑震荡患者进行了回顾性审查。收集患者人口统计数据、病史，包括既往脑震荡、初始症状严重程度评分（SSS）、损伤机制和恢复时间。进行单变量和多变量分析，以确定既往脑震荡病史、患者和损伤特征与症状评分和恢复时间的关联。

总共纳入 266 名患者，平均年龄 15.4 岁（年龄范围 13-27 岁）。据报道，35% 的患者既往患有脑震荡。每个患者既往脑震荡的次数与症状严重程度、恢复时间或 28 天内恢复没有显着相关。在单变量分析中，男性和运动相关脑震荡 (SRC) 与较低的 SSS 和较短的恢复时间相关，但在多变量分析中则不然。然而，与非运动性脑震荡机制相比，SRC 在 28 天内恢复的几率高出 2.3 倍 (p = 0.04)。单变量分析中精神疾病史与较高的 SSS 以及单变量和多变量分析中较长的恢复时间相关。多变量对数线性回归还表明，有精神病史的人在 28 天内康复的几率要低 5 倍。

这项研究的结果表明，先前脑震荡次数的增加与青少年急性脑震荡后出现的 SSS 较高的趋势相关，但与恢复时间或延迟（> 28 天）恢复没有显着相关。研究发现，有精神病史与较长的恢复时间和较低的早期（≤ 28 天）恢复几率显着相关。未来有必要进行前瞻性、长期和系统的研究，以确定对有多次脑震荡病史的青少年和年轻成年患者的最佳咨询和管​​理。