Changes in Driving Behaviors After Concussion in Adolescents.
Changes in Driving Behaviors After Concussion in Adolescents.
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DOI：
10.1016/j.jadohealth.2020.10.009
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Arbogast KB
中科院分区：
文献类型：
--
作者：
McDonald CC;Jain D;Storey EP;Gonzalez M;Master CL;Arbogast KB
尽管恢复学习、锻炼和运动有基于证据的指导方针，但调查脑震荡后恢复驾驶的研究有限。目的是描述和比较青少年脑震荡后的驾驶行为。我们使用 Minds Matter 脑震荡登记处查询了 16-19 岁青少年的数据，这些青少年在受伤后 28 天以内被诊断为脑震荡，并于 2017 年 1 月 31 日至 2018 年 8 月 31 日在专门护理脑震荡项目中就诊。结果包括患者报告： 受伤后驾驶行为的改变；脑震荡后症状调查表（PCSI）；回到学校，锻炼身体。还审查了提供者在初步临床评估后返回学校的建议。进行了描述性统计、ANCOVA 和卡方检验。在 332 名驾驶员中（46.1% 为女性；平均年龄 17.5 岁，95% CI，17.4-17.6），46.9% 的人受伤后恢复驾驶。在那些重新开车的人中，58.9% 的人表示“驾驶没有任何改变”。 “有变化驾驶”（48.7，95% CI：42.2-55.2）的 PCSI 得分高于“无变化驾驶”（27.4，95% CI：22.3-32.5，p<0.01）和“受伤后未驾驶”（42.3，95% CI：38.4-46.3， p<0.01）。在 332 名驾驶员中，很少有人恢复锻炼（15.4%）或组织体育活动（6.0%）。在校学生 (n=291) 中，只有 8.9% 的学生在临床评估后被建议返回完整的教学日。许多青少年在脑震荡后继续开车，尽管尚未恢复锻炼或运动。十分之九的人被建议返回学校并提供住宿，以开始逐渐增加认知活动，这表明逐渐增加驾驶可能是合理的。
Although return to learn, exercise, and sports have evidence-based guidelines, there is limited research investigating return to driving after concussion. The purpose was to characterize and compare adolescent driving behaviors after concussion. Using the Minds Matter Concussion Registry, we queried data of adolescents, ages 16-19, diagnosed with a concussion ≤28 days of injury and seen 1/31/17-8/31/18 at the specialty care concussion program. Outcomes included patient report of: changes post-injury driving behaviors; Post-Concussion Symptom Inventory (PCSI); return to school, and exercise and sports. Provider recommendations for return to school after initial clinical assessment were also examined. Descriptive statistics, ANCOVA, and chi-square tests were performed. Of the 332 drivers (46.1% female; mean age 17.5 years, 95% CI, 17.4-17.6), 46.9% had returned to driving since injury. Of those who returned to driving, 58.9% reported “Driving with No Changes.” PCSI score was higher among “Driving with Changes” (48.7, 95% CI: 42.2-55.2) than “Driving with No Changes” (27.4, 95% CI: 22.3-32.5, p<0.01) and “Has Not Driven Since Injury” (42.3, 95% CI: 38.4-46.3, p<0.01). Among the 332 drivers, few had returned to exercise (15.4%) or organized sports (6.0%). Of those in school (n=291), only 8.9% were provider recommended to return to full school days after clinical assessment. Many adolescents continued to drive after concussion, despite not yet having returned to exercise or sport. Nine out of ten were advised to return to school with accommodations to begin a gradual increase in cognitive activity, suggesting a gradual increase in driving may be justified.
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