Babl Franz E, Dionisio Diana, Davenport Lucy, Baylis Amy, Hearps Stephen J C, Bressan Silvia, Thompson Emma J, Anderson Vicki, Oakley Ed, Davis Gavin A
Emergency Department, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia;
Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Pediatrics. 2017 Aug;140(2). doi: 10.1542/peds.2016-3258.
The Sport Concussion Assessment Tool version 3 (SCAT3) and its child version (ChildSCAT3) are composite physical and neuropsychological scoring systems used to assess athletes after sport-related concussion. Based on limited validation data, we aimed to evaluate the ability of SCAT3 and ChildSCAT3 to differentiate children aged 5 to 16 years with concussion from controls.
Prospective observational study of children in the emergency department with concussion (CONC group) and 2 control groups ([1] upper-limb injury [ULI] and [2] Well children) with equal-sized subgroups in 3 age bands of 5 to 8, 9 to 12, and 13 to 16 years. ChildSCAT3 was used for participants aged 5 to 12 years, and SCAT3 was used for participants aged 13 to 16 years. Differences between study groups were analyzed by using analysis of variance models, adjusting for age and sex.
We enrolled 264 children (90 CONC, 90 ULI, and 84 Well) in equal-sized age bands. The number and severity of child- and parent-reported symptom scores were significantly higher in the CONC group than either control group ( < .001). Mean double (ChildSCAT3 < .001) and tandem stance errors (both ≤ .01) were also significantly higher, and immediate memory was significantly lower for the CONC group ( < .01). No statistically significant group differences were found for orientation and digit backward tasks. There were no significant differences between ULI and Well control groups.
Overall, SCAT3 and ChildSCAT3 can differentiate concussed from nonconcussed patients, particularly in symptom number and severity.
运动性脑震荡评估工具第3版（SCAT3）及其儿童版（ChildSCAT3）是用于评估与运动相关脑震荡后运动员的综合身体和神经心理评分系统。基于有限的验证数据，我们旨在评估SCAT3和ChildSCAT3区分5至16岁脑震荡儿童与对照组的能力。
对急诊科的儿童进行前瞻性观察研究，包括脑震荡组（CONC组）和2个对照组（[1]上肢损伤组[ULI]和[2]健康儿童组），在5至8岁、9至12岁和13至16岁这3个年龄组中有大小相等的亚组。5至12岁的参与者使用ChildSCAT3，13至16岁的参与者使用SCAT3。采用方差分析模型分析研究组之间的差异，并对年龄和性别进行调整。
我们纳入了264名年龄组大小相等的儿童（90名CONC组、90名ULI组和84名健康儿童组）。CONC组中儿童和家长报告的症状评分数量和严重程度显著高于任何一个对照组（P<0.001）。CONC组的平均双脚（ChildSCAT3，P<0.001）和串联站立误差（两者P≤0.01）也显著更高，且即时记忆显著更低（P<0.01）。在定向和数字倒背任务方面未发现组间有统计学显著差异。ULI组和健康儿童对照组之间无显著差异。
总体而言，SCAT3和ChildSCAT3能够区分脑震荡患者和非脑震荡患者，尤其是在症状数量和严重程度方面。
