• Chad A Asplund, Douglas B McKeag, and Cara H Olsen.
• Department of Family Practice, DeWitt Army Community Hospital, Fort Belvoir, VA 22060, USA. chad.asplund@us.army.mil
• Clin J Sport Med. 2004 Nov 1; 14 (6): 339-43.

ObjectiveTo assess predictive value of concussion signs and symptoms based on return-to-play timelines.DesignPhysician practice study without diagnosis that includes presentation, initial and subsequent treatment, and management of concussion.SettingNational multisite primary care sports medicine provider locations.ParticipantsTwenty-two providers at 18 sites; 101 athletes (91 men, 10 women in the following sports: 73 football, 8 basketball, 8 soccer, 3 wrestling, 2 lacrosse, 2 skiing, 5 others; 51 college, 44 high school, 4 professional, and 2 recreational).Main Outcome MeasurementsDuration of symptoms, presence of clinical signs, and time to return to play following concussion.ResultsOne hundred one concussions were analyzed. Pearson chi2 analysis of common early and late concussion symptoms revealed statistical significance (P < 0.05) of headache >3 hours, difficulty concentrating >3 hours, any retrograde amnesia or loss of consciousness, and return to play >7 days. There appeared to be a trend in patients with posttraumatic amnesia toward poor outcome, but this was not statistically significant.ConclusionsWhen evaluating concussion, symptoms of headache >3 hours, difficulty concentrating >3 hours, retrograde amnesia, or loss of consciousness may indicate a more severe injury or prolonged recovery; great caution should be exercised before returning these athletes to play.

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