Objectives To examine the relationship between Concussion Symptom Clusters (CSCs) and return-to-play time using a representative sample of U.S. college athletes with sports-related concussions. Background Recent evidence regarding concussion symptoms have been observed to be an important element of concussion severity, and potentially a predictor of return-to-play time. However, there is a paucity of data examining the associations between Concussion Symptom Clusters (CSCs) and return-to-play time in the U.S. college athlete population. Methods Data from the 2009-2010 to 2013-2014 academic years (n=1670) were obtained from the Datalys Center for Sports Injury and Prevention Inc. database. Exploratory factor analytic methods were applied, and the resulting factors were used in multinomial regression modeling to identify associations between CSCs and return-to-play time. ResultsA 4-factor solution accounted for 48.8% of the variance and included: audio-vestibular, somatic, amnesic, and affective factor structure. Audio-vestibular symptoms were associated with increased odds of prevented participation at 7-13 days, 14-29 days, greater than 30 days, and out for remainder of season, respectively (p Conclusion Specific CSCs were significantly associated with return-to-play time in college athletes, (p<0.05).

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