PM1070: Adolescent Report of Symptoms and Returning to Driving After Concussion

Background: Adolescents account for over 50% of the 1.9 million yearly pediatric concussions. Although return to learn, exercise, and sports have evidence-based guidelines, there is limited research investigating return to driving after concussion. Given the young driver risk for motor vehicle crashes, evidence to safely return adolescents to driving after concussion is needed. This study provides preliminary data on characterizing returning to drive after concussion in a sample of adolescents.

Methods: Concussed adolescents, ages 16.5-18 years and ≤28 days of injury, were recruited through a large integrated pediatric health system to enroll into an experimental driving simulation protocol or observational on-road data collection protocol. At enrollment, all adolescents completed a self-report survey including demographic information, information on if and when they had returned to drive since injury, and pre-injury and current concussion symptoms (Post-concussion Symptom Inventory (PCSI)). Adolescents also downloaded an application (ReCoups) for daily self-report symptom monitoring and details of their daily driving activities for a period of up to 3-months after enrollment. For this analysis, we describe return to driving status from the enrollment survey, total PCSI scores, and ReCoups daily symptom monitoring. Recruitment is ongoing and the most up to date data will be presented at the Annual Meeting.

Results: Thirty-two concussed adolescents (65% female, 74% White) had a mean age of 17.2 (sd 0.6) years and a mean licensure length of 9.8 (sd 7.4) months. At enrollment, they were a mean of 15 (sd 8) days since injury and current mean PCSI was 26.4 (sd 25.1). They reported pre-injury PCSI as 11.6 (sd 14.1). At enrollment, 75% (n=24) had already gone back to driving, with a self-report of returning to drive within a mean of 6 (sd 5.5) days of injury. Of this back to driving cohort, their mean PCSI was 17.4 (sd 20.1) (mean pre-injury PCSI of this cohort was 9.7 (sd 12.6)). Of the 25% (n=8) that had not yet gone back to driving at enrollment, daily reports from ReCOUPS and bi-weekly check-ins indicated that 4 subjects returned to driving during participation in the study and did so within a mean of 19.5 days (sd 9.6) after injury. Their mean PCSI score on day of returning to drive was 21.8 (sd 12.7) (mean pre-injury PCSI of this cohort was 10.3, (sd 7.4)).

Conclusion: Results from this study begin to characteristics returning to drive after concussion in adolescents. Overall, most concussed adolescents returned to driving within a week after injury, even while still experiencing symptoms. Some adolescents took longer to return to driving and still had symptoms that nearly doubled their pre-injury reports. Results from this ongoing study will help provide evidence for clinicians as they guide families in their returning to drive experiences.