PINK Concussions, Norwalk, Connecticut, USA.
Department of Speech & Hearing Science, The Ohio State University, Columbus, Ohio, USA.
Brain Inj. 2022 May 12;36(6):714-721. doi: 10.1080/02699052.2022.2034954. Epub 2022 Feb 7.
Examine how demographic and injury factors impact identification and management of concussion in students.
Prospective observational cohort. Pre-K - 12th grade students within a large, urban school district reported to school with concussion during 2015-2019. Participants were grouped into Elementary/Middle School (E/MS) and High School (HS) and compared by sex, concussion history, injury setting and mechanism, time to medical evaluation and clearance, absences, and recommended accommodations.
154 E/MS and 230 HS students reported to school with physician-diagnosed concussion. E/MS students experienced fewer concussions at school and from sports than HS. More E/MS males than females sustained concussions, while this difference was reversed for HS. Time-to-evaluation was longer for E/MS, specifically female E/MS students and those injured outside of school. E/MS males were cleared more quickly than females. In contrast, no differences were found between sexes for HS by injury setting, mechanism of injury, or management factors.
Differences observed in E/MS students by demographic and injury factors are not observed in HS students. Younger students, particularly females or those not injured in school or sports, may be at risk for delayed identification and prolonged time to clearance. Future research should further characterize concussion management in E/MS children.
研究人口统计学和损伤因素如何影响学生脑震荡的识别和管理。
前瞻性观察队列。在 2015-2019 年期间，一个大型城市学区内的学前至 12 年级学生因脑震荡到校报到。参与者分为小学/初中（E/MS）和高中（HS）两个组，比较两组学生的性别、脑震荡史、损伤环境和机制、就医评估和康复时间、缺勤情况和推荐的适应措施。
共有 154 名 E/MS 和 230 名 HS 学生因医生诊断的脑震荡到校报到。E/MS 学生在校内和运动中发生的脑震荡次数比 HS 学生少。E/MS 组中男性脑震荡的发生率高于女性，而在 HS 组中则相反。E/MS 学生的评估时间较长，特别是女性 E/MS 学生和在校外受伤的学生。E/MS 男性比女性康复得更快。相比之下，HS 组在损伤环境、损伤机制或管理因素方面，男女之间没有差异。
在 E/MS 学生中观察到的人口统计学和损伤因素的差异在 HS 学生中没有观察到。年龄较小的学生，特别是女性或非在校内或运动中受伤的学生，可能存在识别延迟和康复时间延长的风险。未来的研究应进一步描述 E/MS 儿童的脑震荡管理情况。
