Micheli Center for Sports Injury Prevention, Sports Concussion Clinic, Division of Sports Medicine, Children’s Hospital Boston, Boston, MA 02115, USA.
J Pediatr. 2013 Sep;163(3):721-5. doi: 10.1016/j.jpeds.2013.03.012. Epub 2013 Apr 26.
To identify predictors of prolonged symptoms in athletes who sustain concussions.
This was a multicenter prospective cohort study of patients in 2 sport concussion clinics. Possible predictors of prolonged symptoms from concussion were compared in 2 groups, those whose symptoms resolved within 28 days and those whose symptoms persisted beyond 28 days. Candidate predictor variables were entered into a logistic regression model that was used to generate aORs.
A total of 182 patients met the inclusion criteria during the study period. The mean patient age was 15.2 ± 3.04 years. More than one-third of the patients (n = 65) underwent computerized neurocognitive testing on their initial visit. On univariate analyses, Post-Concussion Symptom Scale (PCSS) score and all composite scores on computerized neurocognitive testing were apparently associated with prolonged symptom duration. Sex, age, loss of consciousness at time of injury, and amnesia at time of injury were not associated with prolonged symptom duration. After adjusting for potential confounding, only total PCSS score was associated with the odds of suffering prolonged symptoms.
Further efforts to develop clinical tools for predicting which athletes will suffer prolonged recoveries after concussion should focus on initial symptom score.
确定发生脑震荡后症状持续时间延长的运动员的预测因素。
这是一项在 2 个运动性脑震荡诊所进行的多中心前瞻性队列研究。在 2 组患者中比较了可能导致脑震荡后症状持续时间延长的预测因素，一组为症状在 28 天内缓解，另一组为症状持续超过 28 天。将候选预测变量输入逻辑回归模型，生成比值比(aOR)。
在研究期间，共有 182 名患者符合纳入标准。患者的平均年龄为 15.2±3.04 岁。超过三分之一的患者（n=65）在初次就诊时进行了计算机认知测试。在单因素分析中，脑震荡后症状量表（PCSS）评分和计算机认知测试的所有综合评分显然与症状持续时间延长有关。性别、年龄、受伤时是否意识丧失和受伤时是否健忘与症状持续时间延长无关。在调整了潜在的混杂因素后，只有总 PCSS 评分与遭受长时间症状的几率相关。
进一步努力开发预测哪些运动员在脑震荡后会经历长时间恢复的临床工具，应侧重于初始症状评分。
