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Identifying Risks for Persistent Postconcussive Symptoms in a Pediatric Emergency Department: An Examination of a
Insights
A clinical risk score can help predict persistent postconcussive symptoms (PPCS) in children after a concussion. Headache and a higher risk score were linked to increased odds of PPCS.
Area of Science:
- Pediatric Emergency Medicine
- Neurology
- Clinical Risk Assessment
Background:
- Persistent postconcussive symptoms (PPCS) pose a challenge in pediatric concussion management.
- Accurate prediction of PPCS is crucial for timely intervention and resource allocation in emergency departments (EDs).
Purpose of the Study:
- To externally examine a clinical risk score for predicting PPCS in pediatric patients.
- To identify key risk factors associated with the development of PPCS in children.
Main Methods:
- Prospective cohort study involving 85 pediatric patients (ages 5-18) diagnosed with acute concussion.
- Collection of risk factors at diagnosis, followed by a 30-day follow-up to determine PPCS.
- Univariate logistic regression analyses were used to assess the association between risk factors and PPCS.
Main Results:
- Headache (OR 3.37) and a higher total clinical risk score (OR 1.25) were significantly associated with increased odds of PPCS.
- Teenage age group (OR 4.79), history of prolonged concussions (OR 3.41), and risk group (OR 2.23) showed trends toward association with PPCS.
Conclusions:
- The findings support the utility of a multi-variable clinical risk score for ED risk stratification of pediatric concussion patients.
- This tool can aid clinicians in identifying children at higher risk for developing persistent postconcussive symptoms.
Objective:
External examination of a clinical risk score to predict persistent postconcussive symptoms (PPCS) in a pediatric emergency department (ED).
Methods:
Prospective cohort study of 5- to 18-year-old patients diagnosed with an acute concussion. Risk factors were collected at diagnosis and participants (n = 85) were followed to determine PPCS 30 days postinjury. Univariate logistic regression analyses were completed to examine associations of risk factors with PPCS.
Results:
Headache and total clinical risk score were associated with increased odds of PPCS in the univariate analyses, OR 3.37 (95% CI 1.02, 11.10) and OR 1.25 (95% CI 1.02, 1.52), respectively. Additionally, teenage age group, history of prolonged concussions, and risk group trended toward association with PPCS, OR 4.79 (95% CI 0.93, 24.7), OR 3.41 (95% CI 0.88, 13.20), and OR 2.23 (95% CI 0.88, 5.66), respectively.
Conclusion:
Our study supports the use of multiple variables of a clinical risk score to assist with ED risk stratification for pediatric patients at risk for PPCS.
