Purpose

The aim was to describe the demographic and post-injury factors that influence time to return to learn (RTL) among student-athletes enrolled in the Concussion Assessment, Research and Education (CARE) Consortium.

Methods

A total of 47,860 student-athletes enrolled in the National Collegiate Athletic Association-Department of Defense (NCAA-DoD) CARE Consortium study from 2014 to 2020, with 1485 sport-related concussions (SRCs) analyzed in the present dataset. Demographic and post-injury characteristics were calculated using descriptive statistics, followed by Kaplan–Meier estimates to examine median time to return to normal academic performance (i.e., RTL) by sex (male, female), baseline psychiatric conditions (depression, anxiety) and/or learning disorder, NCAA division (I, II, III), SRC history (0, 1, 2, 3+), NCAA sport category (contact, limited contact, non-contact sport), and median difference in baseline/post-injury symptom severity scores (< 21, ≥ 21). Further, a multivariable zero-inflated negative binomial (ZINB) regression model was used to examine their association with RTL.

Results

Overall, time to RTL (mean = 4.96 ± 8.24 days, median = 3.0 [interquartile range = 0.0, 6.0] days) was found to be influenced by several factors resulting in earlier trajectories. Notably, nearly 25% of the sample demonstrated immediate RTL (i.e., 0 days). Among student-athletes who did not immediately RTL, males demonstrated a decreased rate in RTL (rate = 0.79; 95% CI 0.66–0.96) compared to females. Further, student-athletes with a ≥ 21 change in symptom severity score (post-injury baseline) demonstrated a higher rate of RTL (rate = 1.47; 95% CI 1.21–1.79) compared to student-athletes with a symptom severity change score < 21. Lastly, male student-athletes demonstrated two times higher odds (odds ratio = 1.95; 95% CI 1.02–3.73) of immediate RTL compared to female student-athletes. No other covariates were associated with time to RTL.

Conclusion

Collectively, the present findings suggest a rapid return to the classroom following concussion. Specifically, males demonstrated higher odds of time to RTL, whereas those with greater differences in symptom severity resulted in a higher rate of time to RTL among those who did not immediately RTL. Ultimately, these findings support prior work emphasizing an individualized approach to SRC management.

中文翻译：

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影响参加脑震荡评估、研究和教育 (CARE) 研究的 NCAA 学生运动员返回学习时间的因素

目的

目的是描述影响参加脑震荡评估、研究和教育 (CARE) 联盟的学生运动员返回学习时间 (RTL) 的人口统计和受伤后因素。

方法

2014 年至 2020 年，共有 47,860 名学生运动员参加了美国大学体育协会-国防部 (NCAA-DoD) CARE 联盟研究，本数据集中分析了 1485 例运动相关脑震荡 (SRC)。使用描述性统计数据计算人口统计学和受伤后特征，然后采用 Kaplan-Meier 估计来检查按性别（男性、女性）、基线精神状况（抑郁、焦虑）和/或学习障碍、NCAA 级别（I、II、III）、SRC 历史（0、1、2、3+）、NCAA 运动类别（接触性、有限接触性、非接触性运动）以及基线/后期的中位差异-损伤症状严重程度评分（<21，≥21）。此外，使用多变量零膨胀负二项式 (ZINB) 回归模型来检查它们与 RTL 的关联。

结果

总体而言，RTL 时间（平均值 = 4.96 ± 8.24 天，中位数 = 3.0 [四分位距 = 0.0, 6.0] 天）被发现受到多种因素的影响，导致较早的轨迹。值得注意的是，近 25% 的样本表现出立即 RTL（即 0 天）。在没有立即进行 RTL 的学生运动员中，与女性相比，男性的 RTL 发生率较低（比率 = 0.79；95% CI 0.66–0.96）。此外，与症状严重程度变化评分 < 的学生运动员相比，症状严重程度评分变化（受伤后基线）≥ 21 的学生运动员表现出更高的 RTL 发生率（比率 = 1.47；95% CI 1.21–1.79）。 21. 最后，与女学生运动员相比，男学生运动员立即劳教的几率（比值比 = 1.95；95% CI 1.02-3.73）高出两倍。没有其他协变量与 RTL 时间相关。

结论

总的来说，目前的研究结果表明脑震荡后可以迅速返回课堂。具体来说，男性表现出更高的劳动教养时间，而那些症状严重程度差异较大的男性，导致那些没有立即劳动教养的人获得劳动教养的时间更高。最终，这些发现支持了之前的工作，强调了 SRC 管理的个性化方法。