Factors related to adverse long-term outcomes after mild traumatic brain injury in children: a scoping review

Area of Science:

• Pediatric neurology
• Neuroscience
• Public health

Background:

• Mild traumatic brain injury (mTBI) is common in children.
• Long-term adverse outcomes can significantly impact a child's development and quality of life.
• Identifying predictive factors for these outcomes is essential for targeted interventions.

Purpose of the Study:

• To systematically review and identify demographic, premorbid, injury-related factors, and biomarkers associated with long-term adverse outcomes (≥3 months) in children following mTBI.
• To synthesize current evidence on risk factors and their association with post-concussive symptoms and recovery.

Main Methods:

• A scoping review of the literature was conducted.
• Included studies focused on children and adolescents with mTBI.
• Seventy-three publications were analyzed, examining various risk factors and long-term outcomes.

Main Results:

• Twelve long-term adverse outcomes were reported, with post-concussion syndrome (PCS) and recovery being the most studied.
• Forty-nine risk factors were identified, with sex, age, injury mechanism, and prior mTBI being most frequently assessed.
• The influence of these common risk factors on mTBI outcomes was inconsistent across studies, lacking a clear predictive pattern.

Conclusions:

• While factors like sex, age, and injury mechanism are frequently studied, their impact on mTBI outcomes remains inconsistently estimated.
• Current research often focuses on symptom severity and recovery, which may not align with patient-important outcomes.
• Future research should prioritize patient-centered outcomes and employ robust, prospective, population-based studies to reliably predict long-term adverse effects of childhood mTBI.