Epidemiology of Postconcussion Syndrome in Pediatric Mild Traumatic Brain Injury
Epidemiology of Postconcussion Syndrome in Pediatric Mild Traumatic Brain Injury
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DOI：
10.1542/peds.2009-0925
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发表时间：
2010-08-01
期刊：
影响因子：
8
通讯作者：
Dewey, Deborah
中科院分区：
文献类型：
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作者：
Barlow, Karen Maria;Crawford, Susan;Dewey, Deborah
背景技术背景：对于脑震荡后综合征（PCS）是归因于脑损伤还是归因于其他因素（例如单独的创伤、先前存在的心理社会问题或法医学问题），存在很大分歧。我们调查的流行病学和PCS症状的自然史在一个大的队列的儿童轻度创伤性脑损伤（mTBI），并将其与儿童颅外损伤（ECI）进行比较：本调查是一项前瞻性，连续对照队列研究的670名儿童谁提出了三级转诊急诊科与mTBI和197名儿童谁提出了与ECI。对于所有参与者，数据收集使用的电话采访的父母受伤后7至10天。如果父母报告了损伤前症状的变化，则每月继续随访，直至症状消退。结果通过脑震荡后症状量表、Rivermead脑震荡后症状问卷、简明症状量表和家庭评估工具进行测量。结果：mTBI组和ECI组在症状缓解时间的生存曲线上有显著差异（log rank [Mantel-Cox] 11.15，P <0.001）。受伤后3个月，mTBI组中11%的儿童出现症状（6岁以上儿童为13.7%），而ECI组中只有0.5%的儿童出现症状。mTBI组1年时持续症状的患病率为2.3%，ECI组为0.01%。家庭功能和母亲的调整并没有不同groups.CONCLUSIONS：在学龄儿童与mTBI，13.7%有症状3个月后受伤。这一发现不能解释的创伤，家庭功能障碍，或母亲的心理调整。本研究的结果为儿童PCS诊断的有效性提供了明确的支持。儿科2010; 126：e374-e381
BACKGROUND: Much disagreement exists as to whether postconcussion syndrome (PCS) is attributable to brain injury or to other factors such as trauma alone, preexisting psychosocial problems, or medicolegal issues. We investigated the epidemiology and natural history of PCS symptoms in a large cohort of children with a mild traumatic brain injury (mTBI) and compared them with children with an extracranial injury (ECI).METHODS: This investigation was a prospective, consecutive controlled-cohort study of 670 children who presented to a tertiary referral emergency department with mTBI and 197 children who presented with ECI. For all participants, data were collected by use of a telephone interview of a parent 7 to 10 days after injury. If a change from preinjury symptoms was reported by a parent, follow-up continued monthly until symptom resolution. Outcomes were measured by using the Post Concussion Symptom Inventory, Rivermead Postconcussion Symptom Questionnaire, Brief Symptom Inventory, and Family Assessment Device.RESULTS: There was a significant difference between the mTBI and ECI groups in their survival curves for time to symptom resolution (log rank [Mantel-Cox] 11.15, P < .001). Three months after injury, 11% of the children in the mTBI group were symptomatic (13.7% of children older than 6 years) compared with 0.5% of the children in the ECI group. The prevalence of persistent symptoms at 1 year was 2.3% in the mTBI group and 0.01% in the ECI group. Family functioning and maternal adjustment did not differ between groups.CONCLUSIONS: Among school-aged children with mTBI, 13.7% were symptomatic 3 months after injury. This finding could not be explained by trauma, family dysfunction, or maternal psychological adjustment. The results of this study provide clear support for the validity of the diagnosis of PCS in children. Pediatrics 2010; 126: e374-e381