Symptom Burden, School Function, and Physical Activity One Year Following Pediatric Concussion - 17/12/20
, Andrée-Anne Ledoux, PhD 1, 2, Ken Tang, PhD 1, Rhonda Correll, HBScN 1, Keith Owen Yeates, PhD 3, 4, Gerald Gioia, PhD 5, Stephen B. Freedman, MDCM, MSc 4, 6, Gurinder Sangha, MD 7, Kathy Boutis, MD 8, Darcy Beer, MD 9, William Craig, MDCM 10, Emma Burns, MD 11, Angelo Mikrogianakis, MD 12, 13, Alexander S. Dubrovsky, MDCM, MSc 14, 15, Isabelle Gagnon, PT, PhD 14, 16, Jocelyn Gravel, MD 17, Candice McGahern, BA 1, Martin H. Osmond, MDCM 1, 2, Roger Zemek, MD 1, 2for the
Pediatric Emergency Research Canada (PERC) Concussion Team
Abstract |
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.
Le texte complet de cet article est disponible en PDF.Keywords : concussion, youth, symptoms, physical activity, recovery
Abbreviations : 5P, ED, PSCI-P
Plan
Vol 228
P. 190 - janvier 2021 Retour au numéro
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