Analysis of serum cortisol to predict recovery in paediatric sport-related concussion

ABSTRACT

Objective: To study the relationship between acute serum cortisol following pediatric sport-related concussion (SRC) and clinical outcome measures of symptom burden and length to return to sport (RTS)

Methods: Prospective observational study of ice hockey players ages 11–12 recruited prior to the hockey season. Players sustaining a SRC were assessed by a sports medicine physician completed a child Sport Concussion Assessment Tool-3 (childSCAT-3) and serum cortisol samples.

Results: Of 636 ice hockey players enrolled, 41 sustained a SRC. In total, 22 serum cortisol samples were collected, with 14 (63.6%) meeting inclusion criteria. Four players presented with abnormally low cortisol and were more likely to experienced more symptoms (17.8 ± 1.9 vs. 7.5 ± 6.0) more severe symptoms (28.5 ± 5.8 vs. 10.2. ±8.8) and took longer RTS (23 ± 13.6 vs. 14.0.7 ± 7.9.).

Conclusion: Paediatric ice hockey players following SRC with abnormally low cortisol may be more susceptible to experiencing increase symptom burden and take longer to return to sport than players with population-based normal cortisol.

KEYWORDS:

• Fluid biomarkers
• neuroendocrine dysfunction
• athletes
• sport-related concussion
• cortisol

Acknowledgements

Many thanks to Dr. Luz Pallacios-Derflingher for her statistical knowledge. Thank you to Dr. Keith Yeates and Dr. Sean Dukelow for reviewing the manuscript and their excellent input. Finally, thank you to all the students and research assistants who have worked extremely hard on the Safe to Play study. Thank you to Hockey Canada, parents, players and coaches for their support in this study, as this research would not have happened without them.

Declaration of interest

The authors report no declaration of interest.

Additional information

Funding

This study was funded by the Canadian Institute of Health Research (CIHR).