Objective:Consideration of individual differences in recovery after concussion has become a focus of concussion research. Sex and racial/ethnic identity as they may affect reporting of concussion symptoms have been studied at single time points but not over time. Our objective was to investigate the factors of self-defined sex and race/ethnicity in reporting of lingering concussion symptoms in a large sample of adolescents.Participants and Methods:Concussed, symptomatic adolescents (n=849; Female=464, Male=385) aged 13-18 years were evaluated within 30 days of injury at a North Texas Concussion Registry (ConTex) clinic. Participants were grouped by self-defined race/ethnicity into three groups: Non-Hispanic Caucasian (n=570), Hispanic Caucasian (n=157), and African American (n=122). Measures collected at the initial visit included medical history, injury related information, and the Sport Concussion Assessment Tool-5 Symptom Evaluation (SCAT-5SE). At a three-month follow-up, participants completed the SCAT-5SE. Pearson’s Chi-Square analyses examined differences in categorical measures of demographics, medical history, and injury characteristics. Prior to analysis, statistical assumptions were examined, and log base 10 transformations were performed to address issues of unequal group variances and nonnormal distributions. A three-way repeated measures ANOVA (Sex x Race/Ethnicity x Time) was conducted to examine total severity scores on the SCAT-5SE. Bonferroni post-hoc tests were performed to determine specific group differences. SPSS V28 was used for analysis with p<0.05 for significance. Data reported below has been back transformed.Results:A significant interaction of Time by Race/Ethnicity was found for SCAT-5SE scores reported at initial visit and three-month follow-up (F(2, 843)=7.362, p<0.001). To understand this interaction, at initial visit, Race/Ethnicity groups reported similar levels of severity for concussion symptoms. At three month follow-up, African Americans reported the highest level of severity of lingering symptoms (M= 3.925, 95% CIs [2.938-5.158]) followed by Hispanic Caucasians(M= 2.978, 95% CIs [2.2663.845]) and Non-Hispanic Caucasians who were the lowest(M= 1.915, 95% CIs [1.6262.237]). There were significant main effects for Time, Sex, and Race/Ethnicity. Average symptom levels were higher at initial visit compared to three-month follow-up (F(1, 843)=1531.526, p<0.001). Females had higher average symptom levels compared to males (F(1, 843)=35.58, p<0.001). For Race/Ethnicity (F(2, 843)=9.236, p<0.001), Non-Hispanic Caucasians were significantly different than African Americans (p<0.001) and Hispanic Caucasians (p=0.021) in reported levels of concussion symptom severity.Conclusions:Data from a large sample of concussed adolescents supported a higher level of reported symptoms by females, but there were no significant differences in symptom reporting between sexes across racial/ethnic groups. Overall, at three-months, the African American and Hispanic Caucasians participants reported a higher level of lingering symptoms than Non-Hispanic Caucasians. In order to improve care, the difference between specific racial/ethnic groups during recovery merits exploration into the factors that may influence symptom reporting.

中文翻译：

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73 青少年报告挥之不去的脑震荡症状中的性别和种族/民族

目的：考虑脑震荡后恢复的个体差异已成为脑震荡研究的热点。性别和种族/民族身份可能会影响脑震荡症状的报告，因此已在单个时间点进行了研究，但没有随时间的推移进行研究。我们的目的是调查大量青少年样本中报告挥之不去的脑震荡症状时自我定义的性别和种族/民族的因素。 参与者和方法：有脑震荡症状的青少年（n = 849；女性 = 464，男性 = 385） 13-18 岁的儿童在受伤后 30 天内在北德克萨斯州脑震荡登记处 (ConTex) 诊所接受评估。参与者按自定义种族/族裔分为三组：非西班牙裔白种人 (n=570)、西班牙裔白种人 (n=157) 和非裔美国人 (n=122)。初次就诊时收集的措施包括病史、受伤相关信息和运动脑震荡评估工具 5 症状评估 (SCAT-5SE)。在三个月的随访中，参与者完成了 SCAT-5SE。皮尔逊的卡方分析检查了人口统计、病史和损伤特征的分类测量的差异。在分析之前，检查统计假设，并执行以 10 为底的对数转换，以解决不等组方差和非正态分布的问题。进行三向重复测量方差分析（性别 x 种族/民族 x 时间）来检查 SCAT-5SE 的总严重性评分。Bonferroni 进行事后测试以确定特定的组间差异。使用SPSS V28进行分析，显着性p<0.05。下面报告的数据已进行反向转换。 结果：首次就诊和三个月随访时报告的 SCAT-5SE 评分发现，时间与种族/民族存在显着交互作用 (F(2, 843)=7.362，p<0.001 ）。为了了解这种相互作用，在初次就诊时，种族/民族群体报告了相似的脑震荡症状严重程度。在三个月的随访中，非裔美国人报告的挥之不去的症状严重程度最高（M= 3.925，95% CI [2.938-5.158]），其次是西班牙裔白种人（M= 2.978，95% CI [2.2663.845]）和非西班牙裔白种人最低（M= 1.915，95% CI [1.6262.237]）。时间、性别和种族/民族有显着的主效应。与三个月随访相比，初次就诊时的平均症状水平较高 (F(1, 843)=1531.526，p<0.001）。与男性相比，女性的平均症状水平较高（F(1, 843)=35.58，p<0.001）。对于种族/族裔 (F(2, 843)=9.236，p<0.001），非西班牙裔白种人在报告的脑震荡症状严重程度方面与非裔美国人 (p<0.001) 和西班牙裔白种人 (p=0.021) 显着不同。结论：来自脑震荡青少年的大量样本的数据支持女性报告的症状水平较高，但不同种族/族裔群体的性别之间的症状报告没有显着差异。全面的，三个月后，非裔美国人和西班牙裔白种人参与者报告的挥之不去的症状比非西班牙裔白种人更高。为了改善护理，恢复期间特定种族/族裔群体之间的差异值得探索可能影响症状报告的因素。