Resumen
Objectives: To characterize symptom burden, school function, and physical activity in youth 1 year following acute concussion and those with subsequent repeat concussion. Study design: Secondary analysis of Predicting Persistent Postconcussive Problems in Pediatrics prospective, multicenter cohort study conducted in 9 Canadian emergency departments. Participants were children between ages 5 and 18 years who presented consecutively ≤48 hours of concussion and agreed to participate in a post hoc electronic survey 1 year after injury. Outcomes were assessed using a standardized 25-question symptom scale derived from the Post-Concussion Symptom Inventory-Parent; school function and physical activity outcomes were queried. The primary outcome was total symptom score 1 year following concussion, defined as the number of symptoms experienced more than before injury. Results: Of 3052 youth enrolled in the Predicting Persistent Postconcussive Problems in Pediatrics study, 432 (median [IQR] age, 11.5 [9,14] years; 266 [62%] male) completed the 1-year survey; 34 respondents reported a repeat concussion. Following acute concussion, youth were more likely to be symptom-free than following repeat concussion (75% vs 50%; difference = 25% [95% CI 8-41]; P = .002) and to have recovered fully (90% vs 74%; difference = 17% [95% CI 5-34]; P = .002) after 1 year. Although physical symptoms were less 1 year after initial emergency department presentation for both groups (P < .001), youth with a repeat concussion reported greater headache persistence (26% vs 13%; difference = 13% [95% CI 1,31]; P = .024). Both groups returned to their normal school routine (100% vs 95%; difference = 5% [95% CI −5 to 8; P = .618). Youth without repeat concussion more frequently returned to normal physical activities (98% vs 85%; difference = 13% [95% CI 4-28]; P < .0001) and sport (95% vs 82%; difference = 13% [95% CI 3-29]; P = .009). Conclusions: Most youth are symptom-free and fully recovered 1 year following concussion. Some children with repeat concussion have worse outcomes and have delays in returning to normal school routines and sport.
| Idioma original | English |
|---|---|
| Páginas (desde-hasta) | 190-198.e3 |
| Publicación | Journal of Pediatrics |
| Volumen | 228 |
| DOI | |
| Estado | Published - ene. 2021 |
| Publicado de forma externa | Sí |
Nota bibliográfica
Funding Information:Supported by a Canadian Institutes of Health Research (CIHR) operating grant ( MOP 126197 ); a CIHR– Ontario Neurotrauma Foundation Mild Traumatic Brain Injury team grant ( TM1 127047 ); and CIHR planning grant ( MRP 119829 ). The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review or approval of the manuscript; or decision to submit the manuscript for publication. J.v.I. receives speaking honoraria and travel expenses for presentations at scientific meetings and is founder and an instructor for R2P Concussion Management. K.Y. receives research grants from CIHR , Brain Canada , and Alberta Health Services ; receives royalties for book sales from Guilford Press and Cambridge University Press; and occasionally serves as a paid expert in medicolegal cases. G.G. reports being the author of the Postconcussion Symptom Inventory (PCSI); the PCSI is freely available, and he receives no financial benefit for its use. R.Z. is a co-applicant on a competitively funded grant administered by the National Football League through the independent scientific advisory board to fund a prospective concussion study with the goal of preventing concussions; he does not personally receive any funding for this work; his institution receives the operating funds to conduct the research; he has received honoraria from Parachute Canada (a Canadian non-profit for injury prevention) for his role on the Concussion Expert Advisory board. The other authors declare no conflicts of interest.
Funding Information:
Supported by a Canadian Institutes of Health Research (CIHR) operating grant (MOP 126197); a CIHR?Ontario Neurotrauma Foundation Mild Traumatic Brain Injury team grant (TM1 127047); and CIHR planning grant (MRP 119829). The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review or approval of the manuscript; or decision to submit the manuscript for publication. J.v.I. receives speaking honoraria and travel expenses for presentations at scientific meetings and is founder and an instructor for R2P Concussion Management. K.Y. receives research grants from CIHR, Brain Canada, and Alberta Health Services; receives royalties for book sales from Guilford Press and Cambridge University Press; and occasionally serves as a paid expert in medicolegal cases. G.G. reports being the author of the Postconcussion Symptom Inventory (PCSI); the PCSI is freely available, and he receives no financial benefit for its use. R.Z. is a co-applicant on a competitively funded grant administered by the National Football League through the independent scientific advisory board to fund a prospective concussion study with the goal of preventing concussions; he does not personally receive any funding for this work; his institution receives the operating funds to conduct the research; he has received honoraria from Parachute Canada (a Canadian non-profit for injury prevention) for his role on the Concussion Expert Advisory board. The other authors declare no conflicts of interest. Funding and disclosure information is available at www.jpeds.com.
Publisher Copyright:
© 2020 Elsevier Inc.
ASJC Scopus Subject Areas
- Pediatrics, Perinatology, and Child Health
PubMed: MeSH publication types
- Journal Article
- Multicenter Study
- Research Support, Non-U.S. Gov't