Bressan Silvia, Takagi Michael, Anderson Vicki, Davis Gavin A, Oakley Ed, Dunne Kevin, Clarke Cathriona, Doyle Melissa, Hearps Stephen, Ignjatovic Vera, Seal Marc, Babl Franz E
Murdoch Childrens Research Institute, Melbourne, Victoria, Australia Department of Women's and Children's Health, University of Padova, Padova, Italy.
Murdoch Childrens Research Institute, Melbourne, Victoria, Australia School of Psychological Sciences, University of Melbourne, Victoria, Australia.
BMJ Open. 2016 Jan 12;6(1):e009427. doi: 10.1136/bmjopen-2015-009427.
A substantial minority of children who sustain a concussion suffer prolonged postconcussive symptoms. These symptoms can persist for more than 1 month postinjury and include physical, cognitive, behavioural and emotional changes. Those affected can develop significant disability, diminishing their quality of life. The precise prevalence of postconcussive symptoms following child concussion is unclear, with heterogeneous and at times conflicting results published regarding factors that predict children at risk for developing long-lasting postconcussive symptoms. The aim of the Take C.A.Re (Concussion Assessment and Recovery Research) study is to provide an in-depth multidimensional description of the postconcussive recovery trajectories from a physical, neurocognitive and psychosocial perspective in the 3 months following concussion, with a focus on the early postconcussive period, and identification of factors associated with prolonged recovery.
Take C.A.Re is a prospective, longitudinal study at a tertiary children's hospital, recruiting and assessing patients aged 5-<18 years who present to the emergency department with a concussion and following them at 1-4 days, 2 weeks, 1 month and 3 months postinjury. Multiple domains are assessed: postconcussive symptoms, balance and coordination, neurocognition, behaviour, quality of life, fatigue, post-traumatic stress symptoms, parental distress and family burden. 'Delayed recovery' is operationalised as the presence of ≥ 3 symptoms on the Post Concussive Symptoms Inventory rated as worse compared with baseline. Main analyses comprise analysis of variance (recovery trajectories, delayed vs normal recovery groups) and regression analyses of predictors of recovery (preinjury, acute and family factors).
Ethical approval has been obtained through the Royal Children's Hospital Melbourne Human Research Ethics Committee (33122). We aim to disseminate the findings through international conferences, international peer-reviewed journals and social media.
ACTRN12615000316505.
遭受脑震荡的儿童中有相当一部分会出现长期的脑震荡后症状。这些症状可能在受伤后持续1个月以上,包括身体、认知、行为和情绪变化。受影响的儿童可能会出现严重的残疾,降低他们的生活质量。儿童脑震荡后脑震荡后症状的确切患病率尚不清楚,关于预测有发展为长期脑震荡后症状风险儿童的因素,发表的结果存在异质性,有时甚至相互矛盾。“采取C.A.Re(脑震荡评估与恢复研究)”研究的目的是从身体、神经认知和社会心理角度,对脑震荡后3个月内脑震荡后恢复轨迹进行深入的多维度描述,重点关注脑震荡后的早期阶段,并确定与恢复延长相关的因素。
“采取C.A.Re”是一家三级儿童医院开展的一项前瞻性纵向研究,招募并评估5至未满18岁因脑震荡到急诊科就诊的患者,在受伤后1 - 4天、2周、1个月和3个月对他们进行随访。评估多个领域:脑震荡后症状、平衡与协调、神经认知、行为、生活质量、疲劳、创伤后应激症状、父母困扰和家庭负担。“恢复延迟”定义为脑震荡后症状量表上与基线相比有≥3项症状被评为更严重。主要分析包括方差分析(恢复轨迹、延迟恢复组与正常恢复组)以及恢复预测因素的回归分析(受伤前、急性期和家庭因素)。
已获得墨尔本皇家儿童医院人类研究伦理委员会的伦理批准(33122)。我们旨在通过国际会议、国际同行评审期刊和社交媒体传播研究结果。
ACTRN12615000316505。