NIHR ARC West, Population Health Sciences, University of Bristol, Bristol, UK
NIHR ARC West, Population Health Sciences, University of Bristol, Bristol, UK.
Arch Dis Child. 2023 Jun;108(6):492-497. doi: 10.1136/archdischild-2022-325202. Epub 2023 Mar 31.
To identify demographic, premorbid and injury-related factors, or biomarkers associated with long-term (≥3 months) adverse outcomes in children after mild traumatic brain injury (mTBI).
Scoping review of literature.
Children and adolescents with mTBI.
Any demographic, premorbid and injury-related factors, or biomarkers were included. We excluded genetic and treatment-related factors.
Postconcussion syndrome (PCS), recovery.
Seventy-three publications were included, reporting 12 long-term adverse outcomes, including PCS in 12 studies and recovery in 29 studies. Additional outcomes studied were symptom scores/severity (n=22), quality of life (n=9) and cognitive function (n=9). Forty-nine risk factors were identified across studies. Risk factors most often assessed were sex (n=28), followed by age (n=23), injury mechanism = (n=22) and prior mTBI (n=18). The influence of these and other risk factors on outcomes of mTBI were inconsistent across the reviewed literature.
The most researched risk factors are sex, age and mechanism of injury, but their effects have been estimated inconsistently and did not show a clear pattern. The most studied outcomes are recovery patterns and symptom severity. However, these may not be the most important outcomes for clinicians and patients. Future primary studies in this area should focus on patient-important outcomes. Population-based prospective studies are needed that address prespecified hypotheses on the relationship of risk factors with given outcomes to enable reliable prediction of long-term adverse outcomes for childhood mTBI.
确定与儿童轻度创伤性脑损伤（mTBI）后长期（≥3 个月）不良结局相关的人口统计学、发病前和损伤相关因素或生物标志物。
文献范围综述。
患有 mTBI 的儿童和青少年。
包括任何人口统计学、发病前和损伤相关因素或生物标志物。我们排除了遗传和治疗相关因素。
脑震荡后综合征（PCS）、恢复。
共纳入 73 篇文献，报道了 12 种长期不良结局，包括 12 项研究中的 PCS 和 29 项研究中的恢复。研究中还观察到其他结局包括症状评分/严重程度（n=22）、生活质量（n=9）和认知功能（n=9）。研究中确定了 49 个风险因素。最常评估的风险因素是性别（n=28），其次是年龄（n=23）、损伤机制（n=22）和先前的 mTBI（n=18）。这些和其他风险因素对 mTBI 结局的影响在综述文献中不一致。
研究最多的风险因素是性别、年龄和损伤机制，但它们的影响估计不一致，且没有明显的模式。研究最多的结局是恢复模式和症状严重程度。然而，这些可能不是临床医生和患者最重要的结局。该领域未来的主要研究应侧重于患者重要的结局。需要进行基于人群的前瞻性研究，以解决风险因素与特定结局之间关系的预设假设，从而能够可靠地预测儿童 mTBI 的长期不良结局。
