Russell Kelly, Selci Erin, Chu Stephanie, Fineblit Samuel, Ritchie Lesley, Ellis Michael J
2 Canada North Concussion Network , Winnipeg, Manitoba, Canada .
5 Department of Pediatrics and Child Health, University of Manitoba , Winnipeg, Manitoba, Canada .
J Neurotrauma. 2017 Jul 1;34(13):2147-2153. doi: 10.1089/neu.2016.4704. Epub 2017 Mar 1.
To examine initial and longitudinal health-related quality of life (HRQOL) in adolescent sports-related concussion (SRC) patients, a prospective observational case-series study was conducted among adolescent SRC patients who were evaluated at a multi-disciplinary pediatric concussion program. Health-related quality of life was measured using the child self-report Pediatric Quality of Life Inventory (PedsQL) generic score scale (age 13-18 version) and the PedsQL Cognitive Functioning scale. Initial and longitudinal HRQOL outcomes were compared between patients who did and did not develop post-concussion syndrome (PCS). A total of 63 patients met the inclusion criteria during the study period. The mean age of the cohort was 14.57 years (standard deviation, 1.17) and 61.9% were male. The median time from injury to initial consultation was 6.5 days (interquartile range, 5, 11). At initial consultation, impairments in physical and cognitive HRQOL but not social or emotional HRQOL were observed. Initial symptom burden and length of recovery were associated with greater impairment in physical and cognitive HRQOL. Patients who went on to develop PCS had significantly worse physical and cognitive HRQOL at initial consultation and demonstrated a slower rate of recovery in these domains, compared with those who recovered in less than 30 days. Adolescent SRC was associated with HRQOL impairments that correlated with clinical outcomes. No persistent impairments in HRQOL were detected among patients who achieved physician-documented clinical recovery. Future studies are needed to evaluate the clinical utility of HRQOL measurement in the longitudinal management of adolescent SRC and PCS patients.
为了研究青少年运动相关性脑震荡(SRC)患者的初始和纵向健康相关生活质量(HRQOL),我们对在一个多学科儿科脑震荡项目中接受评估的青少年SRC患者进行了一项前瞻性观察性病例系列研究。使用儿童自我报告的儿童生活质量量表(PedsQL)通用评分量表(13 - 18岁版本)和PedsQL认知功能量表来测量健康相关生活质量。比较了发生和未发生脑震荡后综合征(PCS)的患者的初始和纵向HRQOL结果。在研究期间,共有63名患者符合纳入标准。该队列的平均年龄为14.57岁(标准差为1.17),61.9%为男性。从受伤到初次咨询的中位时间为6.5天(四分位间距为5, 11)。在初次咨询时,观察到身体和认知HRQOL存在损害,但社会或情感HRQOL未受影响。初始症状负担和恢复时间与身体和认知HRQOL的更大损害相关。与在不到30天内康复的患者相比,继续发展为PCS的患者在初次咨询时身体和认知HRQOL明显更差,并且在这些领域的恢复速度较慢。青少年SRC与HRQOL损害相关,且这些损害与临床结果相关。在实现医生记录的临床康复的患者中未检测到HRQOL的持续损害。未来需要进行研究以评估HRQOL测量在青少年SRC和PCS患者纵向管理中的临床效用。