Fineblit Samuel, Selci Erin, Loewen Hal, Ellis Michael, Russell Kelly
1 College of Medicine, University of Manitoba , Winnipeg, Canada .
2 Department of Pediatrics and Child Health, University of Manitoba , Winnipeg, Canada .
J Neurotrauma. 2016 Sep 1;33(17):1561-8. doi: 10.1089/neu.2015.4292. Epub 2016 Apr 15.
Health-related quality of life (HRQOL) is an emerging method to quantify the consequences of pediatric mild traumatic brain injury (mTBI)/concussion in both clinical practice and research. However, to utilize HRQOL measurements to their full potential in the context of mTBI/concussion recovery, a better understanding of the typical course of HRQOL after these injuries is needed. The objective of this study was to summarize current knowledge on HRQOL after pediatric mTBI/concussion and identify areas in need of further research. The following databases from their earliest date of coverage through June 1, 2015 were used: MEDLINE(®), PubMed, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SPORTDiscus, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), and Child Development and Adolescent Studies (CDAS). Studies must have examined and reported HRQOL in a pediatric population after mTBI/concussion, using a validated HRQOL measurement tool. Eight of 1660 records identified ultimately met inclusion criteria. Comprehensive data were extracted and checked by a second reviewer for accuracy and completeness. There appears to be a small but important subgroup of patients who experience poor HRQOL outcomes up to a year or longer post-injury. Potential predictors of poor HRQOL include older age, lower socioeconomic status, or a history of headaches or trouble sleeping. Differing definitions of mTBI precluded meta-analysis. HRQOL represents an important outcome measure in mTBI/concussion clinical practice and research. The evidence shows that a small but important proportion of patients have diminished HRQOL up to a year or longer post-injury. Further study on this topic is warranted to determine the typical longitudinal progression of HRQOL after pediatric concussion.
健康相关生活质量（HRQOL）是一种在临床实践和研究中用于量化小儿轻度创伤性脑损伤（mTBI）/脑震荡后果的新兴方法。然而，为了在mTBI/脑震荡恢复的背景下充分发挥HRQOL测量的潜力，需要更好地了解这些损伤后HRQOL的典型病程。本研究的目的是总结小儿mTBI/脑震荡后HRQOL的现有知识，并确定需要进一步研究的领域。使用了以下从最早覆盖日期到2015年6月1日的数据库：医学索引数据库（MEDLINE®）、PubMed、Embase、Scopus、护理及相关健康文献累积索引（CINAHL）、体育文献数据库（SPORTDiscus）、Cochrane对照试验中心注册库（CENTRAL）、物理治疗证据数据库（PEDro）以及儿童发育与青少年研究数据库（CDAS）。研究必须使用经过验证的HRQOL测量工具，对小儿mTBI/脑震荡后的HRQOL进行了检查和报告。最终确定的1660条记录中有8条符合纳入标准。由第二位审阅者提取并检查综合数据的准确性和完整性。似乎有一小部分但很重要的患者在受伤后长达一年或更长时间内HRQOL结果较差。HRQOL较差的潜在预测因素包括年龄较大、社会经济地位较低或有头痛或睡眠问题史。mTBI的不同定义妨碍了荟萃分析。HRQOL是mTBI/脑震荡临床实践和研究中的一项重要结局指标。证据表明，一小部分但很重要的患者在受伤后长达一年或更长时间内HRQOL下降。有必要对该主题进行进一步研究，以确定小儿脑震荡后HRQOL的典型纵向进展情况。
