Recker Robyn, Alshaikh Enas, Kaur Archana, Yeates Keith Owen, Yang Jingzhen
Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, 43205, USA.
Department of Psychology, University of Calgary, Calgary, AB, Canada.
Qual Life Res. 2023 Dec;32(12):3339-3347. doi: 10.1007/s11136-023-03480-4. Epub 2023 Jul 24.
Concussions can have detrimental on children's cognitive, emotional, behavioral, and/or social functioning. We sought to examine changes in health-related quality of life (HRQOL) and functional disability from pre-injury to 1-week post-concussion, and to symptom resolution among youth ages 11-17 with a concussion.
In this prospective, longitudinal cohort study, 83 concussed youth, ages 11-17, self-reported post-concussion symptoms daily as well as HRQOL and functional disability at baseline (pre-injury, retrospective), 1-week post-concussion, and symptom resolution. We modeled changes in overall and sub-scale HRQOL and functional disability scores over time from pre-injury to 1-week post-concussion and from 1-week post-concussion to symptom resolution using a piecewise linear mixed model, adjusting for potential covariables. Estimated fixed effects with a corresponding adjusted coefficient (beta), along with their 95% confidence intervals are presented.
Overall HRQOL worsened from pre-injury to 1-week post-injury (β = - 5.40, 95%CI - 9.22, - 1.58) but did not change from 1-week post-injury to symptom resolution. Physical HRQOL worsened from pre-injury to 1-week post-injury (β = - 9.90, 95%CI - 14.65, - 5.14) but improved from 1-week post-injury to symptom resolution (β = 1.64, 95%CI 0.50, 2.78), while psychosocial HRQOL showed no change over time. Functional disability worsened from pre-injury to 1-week post-injury (β = 8.36, 95%CI 5.93, 10.79) but with no change from 1-week post-injury to symptom resolution. Youth with symptom duration > 14 days reported worse HRQOL and functional disability than those who recovered in ≤ 14 days and greater daily post-concussion symptom scores were associated with worse HRQOL and functional disability.
Concussions have a negative impact on overall and physical HRQOL and functional disability in youth acutely post-injury. Ratings of HRQOL could be used to inform clinical treatment decisions to assist with the recovery process.
脑震荡会对儿童的认知、情感、行为和/或社交功能产生不利影响。我们试图研究11至17岁脑震荡青少年从受伤前到脑震荡后1周的健康相关生活质量（HRQOL）和功能残疾变化，以及症状缓解情况。
在这项前瞻性纵向队列研究中，83名11至17岁的脑震荡青少年每天自我报告脑震荡后的症状，以及在基线（受伤前，回顾性）、脑震荡后1周和症状缓解时的HRQOL和功能残疾情况。我们使用分段线性混合模型对从受伤前到脑震荡后1周以及从脑震荡后1周到症状缓解期间总体和子量表HRQOL及功能残疾评分的随时间变化进行建模，并对潜在协变量进行调整。给出了估计的固定效应及其相应的调整系数（β）以及它们的95%置信区间。
总体HRQOL从受伤前到受伤后1周恶化（β = -5.40，95%CI -9.22，-1.58），但从受伤后1周到症状缓解没有变化。身体HRQOL从受伤前到受伤后1周恶化（β = -9.90，95%CI -14.65，-5.14），但从受伤后1周到症状缓解有所改善（β = 1.64，95%CI 0.50，2.78），而心理社会HRQOL随时间没有变化。功能残疾从受伤前到受伤后1周恶化（β = 8.36，95%CI 5.93，10.79），但从受伤后1周到症状缓解没有变化。症状持续时间>14天的青少年报告的HRQOL和功能残疾比在≤14天内康复的青少年更差，且每天脑震荡后症状评分越高，HRQOL和功能残疾越差。
脑震荡对青少年受伤后急性期的总体和身体HRQOL以及功能残疾有负面影响。HRQOL评分可用于为临床治疗决策提供信息，以协助恢复过程。
