Utility of pre-injury risk factors and the concussion clinical profiles screening (CP screen) tool for identifying concussion profiles in adolescents

This study determined the combined utility of pre-injury risk factors and Concussion Clinical Profile Screen (CP Screen) items to identify clinician-adjudicated concussion profiles in adolescents. This was a retrospective study of 236 adolescents aged 12-18 who presented to a concussion specialty clinic between 2019 and 2020 within 30 days of injury. Participants completed the CP Screen at their initial evaluation, and clinicians provided blindly adjudicated clinical profiles for each participant. Stepwise logistic regressions and receiver operating characteristic (ROC) curves were conducted. Participants (n = 236; 60.2% male) had a mean age of 14.79 +/- 1.62 years, and most injuries were sport-related (n = 185, 78.4%). Combined pre-injury risk factor and CP Screen item predictors of anxiety/mood (AUC = 0.903) demonstrated outstanding utility; vestibular (AUC = 0.802) demonstrated excellent utility; and ocular (AUC = 0.766), PTM (AUC = 0.729), and cognitive (AUC = 0.723) demonstrated acceptable utility. Select pre-injury risk factors and CP Screen items provided acceptable to outstanding predictive utility for all clinical profiles in adolescents following concussion, highlighting their clinical utility for identifying concussion clinical profiles and subsequent targeted interventions. However, certain pre-injury risk factors and CP Screen items represented multiple profiles, highlighting the potential overlap and the need for clinicians to consider a multidomain evaluation to inform the best treatment approach.