Research Reports - Predicting postconcussion syndrome after mild traumatic brain injury in children and adolescents who present to the emergency department
JAMA Pediatr. 2013 Feb;167(2):156-61
Babcock L, Byczkowski T, Wade SL, Ho M, Mookerjee S, Bazarian JJ
OBJECTIVE To determine the acute predictors associated with the development of
postconcussion syndrome (PCS) in children and adolescents after mild traumatic
brain injury. DESIGN Retrospective analysis of a prospective observational study.
SETTING Pediatric emergency department (ED) in a children's hospital.
PARTICIPANTS Four hundred six children and adolescents aged 5 to 18 years. MAIN
EXPOSURE Closed head trauma. MAIN OUTCOME MEASURES The Rivermead Post Concussion
Symptoms Questionnaire administered 3 months after the injury. RESULTS Of the
patients presenting to the ED with mild traumatic brain injury, 29.3% developed
PCS. The most frequent PCS symptom was headache. Predictors of PCS, while
controlling for other factors, were being of adolescent age, headache on
presentation to the ED, and admission to the hospital. Patients who developed PCS
missed a mean (SD) of 7.4 (13.9) days of school. CONCLUSIONS Adolescents who have
headache on ED presentation and require hospital admission at the ED encounter
are at elevated risk for PCS after mild traumatic brain injury. Interventions to
identify this population and begin early treatment may improve outcomes and
reduce the burden of disease.