Trajectories of Daily Postconcussion Symptoms in Children.
Trajectories of Daily Postconcussion Symptoms in Children.
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儿童日常脑震荡后症状的轨迹。
DOI：
10.1097/htr.0000000000000878
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Yang,Jingzhen
中科院分区：
文献类型：
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作者：
Sullivan,Lindsay;Xu,Menglin;Yeates,KeithOwen;Alshaikh,Enas;Taylor,HGerry;Pommering,Thomas;Yang,Jingzhen
目的：确定脑震荡儿童从急性损伤期到症状消退的日常脑震荡后症状（PCS）的轨迹，并研究与已确定的症状轨迹相关的人口统计学因素和急性PCS。环境和参与者：79名脑震荡患者在受伤72小时内入组，并完成从入组到症状缓解的每日PCS评估调查。设计：这是一项前瞻性队列研究，研究对象为11-17岁的脑震荡儿童。主要测量方法：儿童每天使用脑震荡后症状量表对他们的脑震荡症状进行评分。症状持续时间使用受试者的症状缓解日期进行评估，并编码为二分类变量：(1)PCS持续时间不超过14天或(2)PCS持续时间大于14天。结果：在79名参与者中，大多数是男性（n= 53, 67%），在体育活动中受伤（n= 67, 85%），或者在受伤后持续超过14天的PCS （n= 41, 52%）。基于组的轨迹建模得到4个轨迹组：(1)低急性/消退PCS (n= 39, 49%),(2)中度/持续性PCS (n= 19, 24%),(3)高急性/持续性PCS (n= 13, 16%),(4)高急性/消退PCS （n= 8, 10%）。在人口统计学因素和轨迹组之间没有发现显著的关联。与低急性/消退组相比，损伤时较高的症状负担与高急性/消退组或高急性/持续恢复组的几率增加相关（比值比[or] 1.39, 95% CI= 1.11-1.74; or = 1.33, 95% CI= 1.11-1.60），损伤时较高的症状严重程度也与之相关（or = 1.09, 95% CI= 1.03-1.15; or = 1.06, 95% CI= 1.02-1.11）。结论：我们的研究结果可以帮助临床医生识别脑震荡儿童的缓慢恢复轨迹，并实施早期，个性化的治疗计划，促进脑震荡儿童的最佳恢复。
Objectives:To identify trajectories of daily postconcussion symptoms (PCS) from the acute postinjury period to symptom resolution among concussed children and examine demographic factors and acute PCS associated with the identified symptom trajectories.Setting and Participants:Seventy-nine participants with a concussion were enrolled within 72 hours of injury and completed a daily survey that assessed PCS from enrollment until symptom resolution.Design:This was a prospective cohort study among concussed children aged 11–17 years.Main Measures:Children rated their concussion symptoms daily using the Post-Concussion Symptom Scale. Symptom duration was assessed using participants' date of symptom resolution and coded as a dichotomous variable:(1) PCS duration 14 days or less or (2) PCS duration longer than 14 days.Results:Of the 79 participants, most were male (n= 53, 67%), injured during a sporting activity (n= 67, 85%), or had PCS that persisted for more than 14 days post-injury (n= 41, 52%). Group-based trajectory modeling yielded 4 trajectory groups:(1) low acute/resolved PCS (n= 39, 49%),(2) moderate/persistent PCS (n= 19, 24%),(3) high acute/persistent PCS (n= 13, 16%), and (4) high acute/resolved PCS (n= 8, 10%). No significant associations were found between demographic factors and the trajectory group. A higher symptom burden at injury was associated with an increased odds of being in the high acute/resolved or high acute/persistent recovery groups than being in the low acute/resolved group (odds ratio [OR] 1.39, 95% CI= 1.11-1.74; OR= 1.33, 95% CI= 1.11-1.60, respectively), as was a higher symptom severity at injury (OR= 1.09, 95% CI= 1.03-1.15; OR= 1.06, 95% CI= 1.02-1.11, respectively).Conclusion:Our findings may help clinicians identify concussed children on slower recovery trajectories, and implement early, individualized treatment plans that foster optimal recovery for concussed children.