Sports Medicine Center, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, CO, USA.
School of Medicine, Departments of Orthopedics and Pediatrics, St. Louis Children's Hospital and Washington University School of Medicine, St. Louis, MO, USA.
Phys Sportsmed. 2024 Dec;52(6):592-600. doi: 10.1080/00913847.2024.2344435. Epub 2024 Apr 22.
To understand factors associated with missed academic time after concussion to improve support for patients. Our goal was to assess patient-specific predictors of total school time lost after pediatric/adolescent concussion.
We performed a prospective cohort study of children and adolescents (8-18 years of age) seen within 14 days of concussion from seven pediatric medical centers across the United States. We collected outcomes via the Concussion Learning Assessment & School Survey (CLASS) and constructed a multivariable predictive model evaluating patient factors associated with school time loss.
167 patients participated (mean age = 14.5 ± 2.2 years; 46% female). Patients were assessed initially at 5.0 ± 3.0 days post-injury and had a final follow-up assessment 24.5 ± 20.0 days post-concussion. Participants missed a median of 2 days of school (IQR = 0.5-4), and 21% reported their grades dropped after concussion. Higher initial symptom severity rating (β = 0.06, 95% CI = 0.03-0.08, < 0.001) and perception of grades dropping after concussion (β = 1.37, 95% CI = 0.28-2.45, = 0.01) were significantly associated with more days of school time missed after concussion. Those who reported their grades dropping reported missing significantly more school (mean = 5.0, SD = 4.7 days missed of school) than those who reported their grades did not drop (mean = 2.2, SD = 2.6 days missed of school; < 0.001; Cohen's d = 0.87).
Children and adolescents reported missing a median of 2 days of school following concussion, and more missed school time after a concussion was associated with more severe concussion symptoms and perception of grades dropping. These findings may support recommendations for minimal delays in return-to-learn after concussion.
了解与脑震荡后学业时间损失相关的因素，以更好地为患者提供支持。我们的目标是评估儿童和青少年脑震荡后总学业时间损失的患者特异性预测因素。
我们对美国 7 家儿科医疗中心在脑震荡后 14 天内就诊的儿童和青少年（8-18 岁）进行了前瞻性队列研究。我们通过脑震荡学习评估和学校调查（CLASS）收集结局，并构建了一个多变量预测模型，评估与学业时间损失相关的患者因素。
167 名患者参与（平均年龄 14.5±2.2 岁；46%为女性）。患者在受伤后 5.0±3.0 天首次接受评估，在脑震荡后 24.5±20.0 天进行最终随访评估。参与者平均缺课 2 天（IQR=0.5-4），21%的人报告脑震荡后成绩下降。较高的初始症状严重程度评分（β=0.06，95%CI=0.03-0.08， < 0.001）和脑震荡后成绩下降的感知（β=1.37，95%CI=0.28-2.45， = 0.01）与脑震荡后错过更多的学校时间显著相关。那些报告成绩下降的人报告错过了明显更多的学校（平均缺课 5.0，SD=4.7 天），而那些报告成绩没有下降的人（平均缺课 2.2，SD=2.6 天； < 0.001；Cohen's d=0.87）。
儿童和青少年报告脑震荡后平均缺课 2 天，脑震荡后错过更多的学校时间与更严重的脑震荡症状和成绩下降的感知相关。这些发现可能支持脑震荡后尽快恢复学习的建议。
