Girls Suffer Worse Concussions than Boys

Disclaimer

2014-0507 ConcussionsThe inspiration for this post was an article written by Kathleen Doheny for HealthDaily. Text under the heading “Article” was written by Doheny. This post is not a critique of the article, but an evaluation of the study conclusions upon which the article is based. I have not examined the study data, nor have I read the final report. I am not a statistician, and I receive no compensation by agreeing or disagreeing with the study conclusions.

Article

Girls who suffer a concussion may have more severe symptoms that last longer compared to boys, according to new research that builds on other studies finding gender differences.

“There have been several studies suggesting there are differences between boys and girls as far as [concussion] symptom reporting and the duration of symptoms,” said Dr. Shayne Fehr, a pediatric sports medicine specialist at Children’s Hospital of Wisconsin.

In his new study, Fehr also found those differences. He tracked 549 patients, including 235 girls, who sought treatment at a pediatric concussion clinic.

Compared to the boys, the girls reported more severe symptoms and took nearly 22 more days to recover, said Fehr, also an assistant professor of pediatric orthopedics at the Medical College of Wisconsin.

A concussion is any brain injury that disturbs normal functioning. Concussions are typically caused by a jolt or blow to the head, often in collision sports such as hockey or football, according to the American Academy of Pediatrics (AAP).

In the new study, Fehr tracked patients aged 10 to 18, all treated between early 2010 and mid-2012. Each patient reported on their symptoms, how severe they were and how long it took from the time of the injury until they were symptom-free.

In addition to reporting more severe symptoms, girls took an average of 56 days to be symptom-free. In comparison, the boys took 34 days. Overall, the time to recovery was 44 days when boys and girls were pooled.

That duration of symptoms, Fehr said, is much longer than what people commonly think. “Commonly you hear that seven to 10 days [for recovery] is average,” he said. Fehr did not find age to be linked with severity of symptoms.

The top five reported symptoms were headache, trouble concentrating, sensitivity to light, sensitivity to sound and dizziness. Boys and girls, in general, reported the same types of symptoms, Fehr said, but the girls reported more severity and for a longer time period.

“This confirms what has been reported before,” said Dr. John Kuluz, director of traumatic brain injury and neurorehabilitation at Miami Children’s Hospital, who reviewed the findings. While he said the 44-day recovery seems lengthy, he added that it probably reflects the boys and girls studied. They all went to a concussion clinic, so their injuries may have been more severe.

For both genders, it’s important to be seen by a doctor and not return to play prematurely, which can be dangerous or even fatal, according to the AAP. Anyone with a history of concussion is at higher risk for another injury.

Shadow of Doubt

I am not suggesting the conclusion is wrong based on the data in the study, but I am suggesting the data may be flawed. According to the article, the study by Dr. Shayne Fehr “builds on other studies.” Therefore, Dr. Fehr’s conclusion is at least partially based on the flaws that may exist in earlier studies as well as the flaws in his own data.

Although we are told Dr. Fehr “tracked 549 patients, including 235 girls” we are not told if the sample of patients is random. Are the kids from different locations? Are the kids from different socioeconomic groups? Were all concussions at all clinics diagnosed in exactly the same way? Were the concussions determined subjectively or objectively?

We are also told that compared to the boys, “the girls reported more severe symptoms and took nearly 22 more days to recover [than boys].” However, we are not told how any cultural or societal influences were filtered out of the study. For example are boys, or their parents, less likely to report symptoms than girls or their parents. When questioned, do boys tend to self-report fewer symptoms than girls?

One other factor that concerns me is the data is subjective and comes from people who admittedly have a brain injury. I’m not certain that self-reported, subjective information, from a concussed person is the best data upon which to build a study.

As Dr. John Kuluz mentioned in his review of the study, “it probably reflects the boys and girls studied. They all went to a concussion clinic, so their injuries may have been more severe.” In other words, the study results may not be accurate.

Call to Action

What do you think about the study conclusion? Do you believe girls have more severe concussions and symptoms that last longer than boys? Please share your comments in the text box below this post.

Credits

Thanks to Kathleen Doheny for writing the article; WebMD HealthDaily for committing its resources to the article; Google for helping me find the article and the picture I used in this post; and all the other people who, directly and indirectly made it possible for me to include the picture and text I used in this post.

 

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