OBJECTIVES To identify which aspects of initial clinical assessment for sport-related mild traumatic brain injury (SR-mTBI) predict whether an athlete achieves symptom resolution within 14 days of the injury. RESEARCH DESIGN Retrospective cohort study using prospectively collected data. METHODS Clinical assessment data were collected from 568 patients diagnosed with SR-mTBI at a single medical clinic between February 2017 and December 2018. Demographic data, medical history, SCAT-5 testing, and physician notes were included in the data set. Data were processed and analysed to identify a shortlist of predictor variables to develop a logistic regression model to discriminate between SR-mTBI symptom resolution that occurred in ≤ 14-days or > 14-days. The data were randomly divided into model development and validation subsamples. The top 15 models were analysed to determine the predictor variables to be included in the final logistic regression model. The final model was then applied to the validation subsample. RESULTS Half of the athlete participants in this study experienced > 14-day symptom resolution. The final logistic regression model included sex, symptom reporting at initial assessment and presentation with a physiological predominant symptom cluster. The model accounted for 0.90 and 0.85 of the area under the curve and predicted recovery trajectory with 81% and 76% accuracy for the training and validation subsamples, respectively. CONCLUSIONS Being female, reporting a higher Positive Symptom Total at initial assessment, and being less likely to have a physiological predominant symptom cluster at initial assessment predicted > 14 versus ≤ 14-day SR-mTBI symptom resolution with a high level of accuracy.

中文翻译：

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使用初步临床评估结果预测与运动相关的mTBI症状缓解轨迹：一项回顾性队列研究。

目的确定运动相关性轻度颅脑损伤（SR-mTBI）的初始临床评估的哪些方面，可以预测运动员在受伤后14天内是否达到症状缓解。研究设计使用前瞻性收集的数据进行回顾性队列研究。方法在2017年2月至2018年12月期间，从单个医疗诊所收集的568例SR-mTBI诊断为患者的临床评估数据中包括人口统计学数据，病史，SCAT-5测试和医生记录。对数据进行处理和分析以识别预测变量的短列表，以开发逻辑回归模型来区分≤14天或> 14天的SR-mTBI症状缓解。数据被随机分为模型开发和验证子样本。分析了前15个模型，以确定最终logistic回归模型中将包含的预测变量。然后将最终模型应用于验证子样本。结果这项研究的一半运动员参与者经历了> 14天的症状缓解。最终的逻辑回归模型包括性别，初步评估时的症状报告以及以生理学为主的症状群的表现。该模型占曲线下面积的0.90和0.85，并预测了训练和验证子样本的预测恢复轨迹，其准确度分别为81％和76％。结论女性为女性，在初次评估时报告的阳性症状总数较高，并且在初次评估时预测的生理性症状簇的可能性较小>