The Effect of Social Disadvantage on Initial Sport-Related Concussion Evaluation Times in 13 to 17-Year-Old Athletes.

IF 2.1 3区医学 Q2 ORTHOPEDICS

Clinical Journal of Sport Medicine Pub Date : 2026-06-08 DOI:10.1097/JSM.0000000000001490

Jai L Horsey, Trevor Anesi, Aneil Saini, Tagalsir F Osama, Kristen Williams, Jacob Jo, Olivia L Prosak, Amad Amedy, Scott L Zuckerman, Douglas P Terry

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引用次数: 0

Abstract

Objective: To evaluate the influence of social disadvantage on time to presentation to care after sport-related concussion (SRC).

Design: Retrospective cohort study.

Setting: The study was conducted using a REDCap database of former patients treated at a regional sports concussion clinic.

Participants: Athletes 13 to 17-year-old, who sustained an SRC and were examined at the regional sports concussion clinic between 11/2017 and 04/2022.

Intervention: Area Deprivation Index (ADI) score was calculated using the patient's zip codes.

Main outcome measures: Time to present to a regional sports concussion clinic (days) and time to present to any healthcare setting (days). χ2 analysis and logistic regression assessed for differences between ADI quartiles and predictors of time to presentation, respectively.

Results: A total of 916 patients were included (mean age = 15.8 ± 1.3). The median time to presentation to any healthcare setting was 2 days (IQR: 0-6). Highest ADI quartile patients (ie, most socially disadvantaged) were more likely to be Hispanic/Latino (P = 0.003), non-White (P < 0.001), public school attendees (P < 0.001), and have had nonprivate insurance (P < 0.001). These patients also took longer to present to a regional sports concussion clinic (P < 0.001) compared with lower ADI quartiles. ADI score (B = 0.095, P < 0.001) and family history of migraines (B = 0.177, P = 0.006) significantly predicted longer times to clinic presentation.

Conclusion: Greater social disadvantage was associated with a longer time to present to concussion specialty care. Ensuring those with fewer resources have early access to sports concussion care represents an actionable opportunity to reduce this healthcare disparity.

Clinical relevance: Social determinants of health may be barriers to timely and equitable access to specialty concussion care.

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社会劣势对13 ~ 17岁运动员初始运动相关脑震荡评估时间的影响。

目的：探讨社会不利因素对运动相关脑震荡（SRC）患者就诊时间的影响。设计：回顾性队列研究。背景：本研究使用REDCap数据库进行，该数据库收集了在某地区运动脑震荡诊所接受治疗的前患者。参与者：13至17岁的运动员，他们患有SRC，并于2017年11月至2022年4月在区域运动脑震荡诊所接受检查。干预措施：根据患者的邮政编码计算区域剥夺指数（ADI）评分。主要结果测量：到区域运动脑震荡诊所就诊的时间（天）和到任何医疗机构就诊的时间（天）。χ2分析和逻辑回归分别评估了ADI四分位数和就诊时间预测因子之间的差异。结果：共纳入916例患者，平均年龄= 15.8±1.3岁。到任何医疗机构就诊的中位时间为2天（IQR: 0-6）。最高ADI四分位数的患者（即最不利的社会地位）更可能是西班牙裔/拉丁裔（P = 0.003），非白人（P < 0.001），公立学校学生（P < 0.001），并有非私人保险（P < 0.001）。与低ADI四分位数患者相比，这些患者到区域性运动脑震荡诊所就诊的时间也更长（P < 0.001）。ADI评分（B = 0.095, P < 0.001）和偏头痛家族史（B = 0.177, P = 0.006）显著预测到临床就诊的时间较长。结论：社会劣势越大，接受脑震荡专科治疗的时间越长。确保那些资源较少的人能够尽早获得运动脑震荡护理，这是一个减少这种医疗差距的可行机会。临床相关性：健康的社会决定因素可能是及时和公平获得专业脑震荡护理的障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Journal of Sport Medicine 医学-生理学

CiteScore

4.70

自引率

7.40%

发文量

185

审稿时长

6-12 weeks

期刊介绍： Clinical Journal of Sport Medicine is an international refereed journal published for clinicians with a primary interest in sports medicine practice. The journal publishes original research and reviews covering diagnostics, therapeutics, and rehabilitation in healthy and physically challenged individuals of all ages and levels of sport and exercise participation.