Nance Michael L, Callahan James M, Tharakan Sasha J, Malamet Peter, Houseknecht Eileen M, Mahoney Kaitilin R, Wiebe Douglas J
a Department of Surgery.
b Department of Pediatrics , Division of Emergency Medicine.
Brain Inj. 2016;30(2):184-90. doi: 10.3109/02699052.2015.1075591. Epub 2015 Dec 29.
To assess feasibility and utility of neurocognitive testing of children evaluated and discharged from the ED with mild traumatic brain injury (MTBI).
Paediatric blunt trauma patients (aged 11-18 years) evaluated in the ED for MTBI and control patients with isolated lower extremity injury were prospectively enrolled. All patients were administered a validated neurocognitive test (ImPACT(©)). Wilcoxon sign rank tests were used to compare reported symptoms and neurocognitive performance between subjects and controls, as well as to matched normative data.
Thirty-nine subjects and 46 controls were enrolled. The MTBI patients had a mean age of 13.9 years (53.8% male). An abnormal symptom score was reported in 89.7% of MTBI subjects (mean score = 29.4, normal ≤ 8), differing significantly (p < 0.05) from controls, in whom 39.1% demonstrated an abnormal score (mean score = 8.7). In all neurocognitive test domains, visual motor speed and reaction time, MTBI patients demonstrated lower scores than normative data (p < 0.05).
Patients with MTBI were more likely than control subjects to have scores on any or all neurocognitive domains below the 25th percentile and 10th percentile. In the ED setting, acute neurocognitive testing of MTBI in children is feasible. This highlights the importance of structured follow-up for this treated and released population.
评估对因轻度创伤性脑损伤（MTBI）在急诊科接受评估并出院的儿童进行神经认知测试的可行性和实用性。
前瞻性纳入在急诊科因MTBI接受评估的儿科钝性创伤患者（年龄11 - 18岁）以及孤立性下肢损伤的对照患者。所有患者均接受经过验证的神经认知测试（ImPACT(©)）。采用Wilcoxon符号秩检验来比较受试者与对照组之间报告的症状和神经认知表现，以及与匹配的常模数据进行比较。
共纳入39名受试者和46名对照。MTBI患者的平均年龄为13.9岁（53.8%为男性）。89.7%的MTBI受试者报告有异常症状评分（平均评分 = 29.4，正常≤8），与对照组有显著差异（p < 0.05），对照组中有39.1%表现出异常评分（平均评分 = 8.7）。在所有神经认知测试领域，即视觉运动速度和反应时间方面，MTBI患者的得分低于常模数据（p < 0.05）。
MTBI患者在任何或所有神经认知领域的得分低于第25百分位数和第10百分位数的可能性高于对照受试者。在急诊科环境中，对儿童MTBI进行急性神经认知测试是可行的。这突出了对这一接受治疗并出院人群进行结构化随访的重要性。
