Pediatric Division, Kaplan Medical Center, Rehovot, Israel.
The Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, 70300, Zerifin, Israel.
Sci Rep. 2022 Mar 14;12(1):4364. doi: 10.1038/s41598-022-08302-0.
Data on epidemiology and prognosticators of persistent post-concussion syndrome (PPCS) after mild traumatic brain injury (mTBI) in the pediatric population is scarce. The aim of this study was to evaluate the prevalence of PPCS in children after mTBI and to identify clinical variables in children who are at high risk for developing PPCS. A multicenter, retrospective matched cohort in which PPCS symptoms were evaluated in children 8-15-year-old, 6-60 months after being admitted to the emergency department because of mTBI. The control group included children admitted to the emergency department because of uncomplicated distal radius fractures. The children's guardians were interviewed for the presence of PPCS symptoms using the "Rivermead Post-Concussion Questionnaire". A multivariable logistic regression model was used to identify predictors of PPCS. Two-hundred and five children were included in the mTBI group and 205 in the control. The median time from the injury was 33.5 months in the mTBI group and 33.8 in the control. The prevalence of PPCS in the mTBI group was 25.3% and PPCS like symptoms in the control was 2.4%, p < 0.001. Within the 6-60 months period, the PPCS prevalence was not influenced by the time that elapsed from the injury. In the mTBI group, motor vehicle accidents and adolescence were found to be risk factors for PPCS. PPCS is underdiagnosed in the pediatric population and 25% of children admitted to the ED due to mTBI may suffer from PPCS. Screening guidelines should be implemented to identify and properly treat these children.
关于儿童轻度创伤性脑损伤 (mTBI) 后持续性脑震荡后综合征 (PPCS) 的流行病学和预后因素的数据很少。本研究旨在评估 mTBI 后儿童 PPCS 的患病率，并确定儿童中发生 PPCS 风险较高的临床变量。在多中心、回顾性匹配队列中，对因 mTBI 入住急诊科 6-60 个月后的 8-15 岁儿童评估 PPCS 症状。对照组包括因单纯桡骨远端骨折入住急诊科的儿童。通过“Rivermead 脑震荡后问卷”，对儿童监护人进行 PPCS 症状的访谈。采用多变量逻辑回归模型识别 PPCS 的预测因素。共有 205 名儿童纳入 mTBI 组，205 名儿童纳入对照组。mTBI 组的损伤后中位数时间为 33.5 个月，对照组为 33.8 个月。mTBI 组 PPCS 的患病率为 25.3%，对照组 PPCS 样症状的患病率为 2.4%，p<0.001。在 6-60 个月期间，PPCS 的患病率不受损伤后时间的影响。在 mTBI 组中，发现机动车事故和青春期是 PPCS 的危险因素。PPCS 在儿科人群中诊断不足，因 mTBI 入住 ED 的 25%的儿童可能患有 PPCS。应实施筛查指南，以识别和正确治疗这些儿童。
