Standardized Assessment of Concussion (SAC): On-Site Mental Status Evaluation of the Athlete Objective: This study investigated the clinical utility of the Standardized Assessment of Concussion (SAC) in detecting concussion in athletes. Method: Athletic trainers administered the SAC to 568 nonconcussed high school and college football players prior to the 1995 and 1996football seasons. Thirty-three of these players experienced concussion and were tested immediately following injury; 28 of the 33 underwent additional follow-up testing 48 hours after the injury. Results: Concussed players scored significantly below nonconcussed controls on all SAC measures and significantly below their own pre-injury baseline performance. Follow-up testing documented return to preinjury baseline. Conclusion: These findings support the SAC's effectiveness in detecting concussion and tracking recovery in order to determine a player's fitness to return to play. Key words: brain injury, concussion, mental status, neuropsychologi- cal tests, sports injuries, Standardized Assessment of Concussion Michael McCrea, PhD Head of Neuropsychology Service* James P. Kelly, MD Director, Brain Injury Program* Christopher Randolph, PhD Associate Professor of Neurology* Private Practice Jon Kluge, PT/ATC Employer and Community Health Services Leader1 Edward Bartolic, PhD Assistant Professor of Psychiatry^' George Finn, ATC Director of Sports Medicine11 Brian Baxter, BS Assistant Athletic Trainer* * Waukesha Memorial Hospital, Waukesba, Wisconsin. ' Rehabilitation Institute of Chicago, Chicago, Illinois. * Loyola University Medical Center, Chicago, Illinois. f Covenant Medical Center, Waterloo, Iowa. 1] Allegheny University of the Health Sciences, Philadelphia, Pennsylvania. ' Bates College, Lewiston, Maine. * University of Wisconsin-Platteville, Platteville, Wisconsin. Address correspondence to M. McCrea, Waukesha Me- morial Hospital, 725 American Avenue, Waukesha, WI 53188. RATIONALE AND SIGNIFICANCE There has been a heightened awareness of the possible effects of concussion suffered by athletes in recent years as brain injury in orga- nized sports becomes the focus of increasing attention from medical personnel responsible for the care of athletes, administrative bodies governing various sports, and the media. Al- though more research has focused on sports- related concussion in recent years, there are few controlled prospective studies in the sci- entific literature.1 Epidemiologic and retro- spective studies have documented football as one of the sports with the highest rates of concussion,2 with an estimated 100,000 such injuries annually in organized football alone (personal communication, John Powell, PhD, The athletic training staff at the following institutions are acknowledged for their help in collecting data dur- ing the 1995 and 1996 seasons: Cedar Falls High School, Waterloo Columbus High School, Waterloo East High School, Waterloo West High School, Philadelphia Roman Catholic High School, Philadelphia Episcopal Academy, St. Ambrose University, Bates College, and Colby College. The authors also acknowledge the coach- ing staff and players at each institution for their coop- eration and participation in the study. JHead Trauma Rehabil 1998;13(2):27-35 © 1998 Aspen Publishers, Inc. 27