Emergency department visits for mild traumatic brain injury in early childhood

Rose, Sean C.; Levine, Deborah A.; Shi, Junxin; Wheeler, Krista K.; Aungst, Taylour; Stanley, Rachel; Beauchamp, Miriam H.

doi:10.1016/j.ajem.2022.12.035

Cited by 4 publications

(3 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The inclusion criteria for the uninjured control group were to be within study age range and to have a typical course of development. The following exclusion criteria applied to all groups: (1) hypoxia, hypotension, or shock; (2) administration of sedative medication; (3) neurosurgical intervention; (4) injury related to suspected or known abuse or assault; (5) legal guardian not present or child in foster care; (6) insufficient parental mastery of English or French; (7) diagnosed, severe, congenital, neurologic, developmental, psychiatric, or metabolic disorder; (8) gestational age younger than 37 weeks; and (9) history of prior TBI. Patients fulfilling the inclusion and exclusion criteria were identified and invited to participate.…”

Section: Participants and Study Protocolmentioning

confidence: 99%

“…Concussions and mild traumatic brain injury (mTBI) are common during early childhood; and, in particular, children aged 5 years and younger have the highest incidence of presentation to emergency departments (EDs) among pediatric groups for injury caused by a direct or indirect force to the head . In the United States, more than 300 000 children present to the ED annually with these types of injuries . Postconcussive symptoms (PCS) are common consequences in older children and adults and include somatic (eg, headache, dizziness), cognitive (eg, confusion, poor concentration), affective (eg, anxiety, sadness), and sleep (eg, fatigue, drowsiness) problems .…”

Section: Introductionmentioning

confidence: 99%

“…1,2 In the United States, more than 300 000 children present to the ED annually with these types of injuries. 3 Postconcussive symptoms (PCS) are common consequences in older children and adults and include somatic (eg, headache, dizziness), cognitive (eg, confusion, poor concentration), affective (eg, anxiety, sadness), and sleep (eg, fatigue, drowsiness) problems. 4,5 In children aged 6 years and older PCS are quantified using caregiver or self-report questionnaires, emerge within hours or days after injury, and typically resolve within 10 to 14 days 6 ; however approximately 31% of children have persisting symptoms 1 month after injury, 7,8 and these are associated with adverse long-term physical, emotional, social, and academic quality of life outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Postconcussive Symptoms After Early Childhood Concussion

Dupont,

Tang,

Beaudoin

et al. 2024

JAMA Netw Open

Self Cite

View full text Add to dashboard Cite

ImportanceResearch on postconcussive symptoms (PCS) following early childhood concussion has been hindered by a lack of measures suitable for this age group, resulting in a limited understanding of their evolution in young children.ObjectiveTo document PCS in the first 3 months after early childhood concussion using a developmentally appropriate measure.Design, Setting, and ParticipantsThis cohort study used data collected at 3 Canadian and 1 US urban pediatric emergency departments (EDs) and 8 Canadian daycares from December 2018 to December 2022 as part of the Kids’ Outcomes and Long-Term Abilities (KOALA) project, a prospective, multicenter, longitudinal cohort study. Participants included children aged 6 to 72 months with early childhood concussion or orthopedic injury (OI) or uninjured children from the community to serve as controls. Data were analyzed from March 2023 to January 2024.ExposureConcussion sustained between ages 6 and 72 months.Main Outcomes and MeasuresPrimary outcomes were cognitive, physical, behavioral and total PCS assessed prior to injury (retrospectively), acutely (within 48 hours), and at 10 days, 1 month, and 3 months after injury or recruitment through caregiver observations using the Report of Early Childhood Traumatic Injury Observations &amp; Symptoms inventory. Group comparisons were analyzed using ordinal regression models.ResultsThe study included 303 children (mean [SD] age, 35.8 [20.2] months; 152 [50.2%] male). Of these, 174 children had a concussion (mean [SD] age, 33.3 [19.9] months), 60 children had an OI (mean [SD] age, 38.4 [19.8] months) and 69 children were uninjured controls (mean [SD] age, 39.7 [20.8] months). No meaningful differences were found between the concussion and comparison groups in retrospective preinjury PCS. Significant group differences were found for total PCS at the initial ED visit (concussion vs OI: odds ratio [OR], 4.33 [95% CI, 2.44-7.69]; concussion vs control: OR, 7.28 [95% CI, 3.80-13.93]), 10 days (concussion vs OI: OR, 4.44 [95% CI, 2.17-9.06]; concussion vs control: OR, 5.94 [95% CI, 3.22-10.94]), 1 month (concussion vs OI: OR, 2.70 [95% CI, 1.56-4.68]; concussion vs control: OR, 4.32 [95% CI, 2.36-7.92]), and 3 months (concussion vs OI: OR, 2.61 [95% CI, 1.30-5.25]; concussion vs control: OR, 2.40 [95% CI, 1.36-4.24]). Significant group differences were also found for domain-level scores (cognitive, physical, behavioral) at various time points.Conclusions and RelevanceIn this early childhood cohort study, concussion was associated with more PCS than OIs or typical development up to 3 months after injury. Given the limited verbal and cognitive abilities typical of early childhood, using developmentally appropriate manifestations and behaviors is a valuable way of tracking PCS and could aid in concussion diagnosis in young children.

show abstract