Time Interval Between Concussions and Symptom Duration
Time Interval Between Concussions and Symptom Duration
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DOI：
10.1542/peds.2013-0432
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发表时间：
2013-07-01
期刊：
影响因子：
8
通讯作者：
Mannix, Rebekah
中科院分区：
文献类型：
--
作者：
Eisenberg, Matthew A.;Andrea, John;Mannix, Rebekah
目的：检验有脑震荡病史的儿童在重复脑震荡后症状持续时间比没有脑震荡病史的儿童更长的假设。方法：对因急性脑震荡到儿童医院急诊科就诊的 11 至 22 岁连续患者进行前瞻性队列研究。主要结果指标是症状消退的时间，通过 Rivermead 脑震荡后症状问卷 (RPSQ) 进行评估。患者和提供者完成了一份调查问卷，描述损伤机制、相关症状、既往病史、检查结果、诊断研究和 RPSQ。然后，患者在脑震荡后 3 个月内连续接受 RPSQ 治疗，或直至所有症状消失。 结果：12 个月内共有 280 名患者入组。有脑震荡史的患者比没有脑震荡史的患者症状持续时间更长（24 天 vs 12 天，P = .02）。与没有这些危险因素的患者相比，既往多次脑震荡的患者（28 天，P = .03）和前一年内遭受过脑震荡的患者（35 天，P = .007）的中位症状持续时间更长。在多变量模型中，既往脑震荡、无意识丧失、年龄 >= 13 和初始 RPSQ 评分 >18 是长期恢复的显着预测因素。 结论：有脑震荡病史的儿童，特别是近期或多次脑震荡，脑震荡后出现长期症状的风险增加。这些发现对重复受伤风险较高的脑震荡患者的治疗具有直接影响。
OBJECTIVE: To test the hypothesis that children with a previous history of concussion have a longer duration of symptoms after a repeat concussion than those without such a history.METHODS: Prospective cohort study of consecutive patients 11 to 22 years old presenting to the emergency department of a children's hospital with an acute concussion. The main outcome measure was time to symptom resolution, assessed by the Rivermead Post-Concussion Symptoms Questionnaire (RPSQ). Patients and providers completed a questionnaire describing mechanism of injury, associated symptoms, past medical history, examination findings, diagnostic studies, and the RPSQ. Patients were then serially administered the RPSQ for 3 months after the concussion or until all symptoms resolved.RESULTS: A total of 280 patients were enrolled over 12 months. Patients with a history of previous concussion had a longer duration of symptoms than those without previous concussion (24 vs 12 days, P = .02). Median symptom duration was even longer for patients with multiple previous concussions (28 days, P = .03) and for those who had sustained a concussion within the previous year (35 days, P = .007) compared with patients without those risk factors. In a multivariate model, previous concussion, absence of loss of consciousness, age >= 13, and initial RPSQ score >18 were significant predictors of prolonged recovery.CONCLUSIONS: Children with a history of a previous concussion, particularly recent or multiple concussions, are at increased risk for prolonged symptoms after concussion. These findings have direct implications on the management of patients with concussion who are at high risk for repeat injuries.