Background: A cluster of cognitive, physical, emotional / behavioral and sleep problems referred to as post-concussion syndrome (PCS) occurs following mild traumatic brain injury (mild TBI) in a subset of children. Limited evidence suggests that patient and injury characteristics contribute to the development of PCS.
Objective: To determine the acute predictors associated with the development of PCS in children.
Methods: Retrospective analysis of a prospective observational study of children ages 5 to 18 years presenting to the Emergency Department (ED) with mild TBI. All patients had data related to the injury recorded during the initial ED visit. Telephone follow-up administration of the Rivermead Postconcussion Questionnaire was conducted at three months post injury. In a convenience sample, serum was analyzed for the biomarker S100B. Univariable and multivariable logistic regressions were performed.
Results: 29% of children presenting to the ED with mild TBI developed had PCS. The most frequent PCS symptom was headache. Predictors of the development of PCS were age, headache on presentation in the ED and admission to the hospital, while controlling for other covariates. S100B levels alone did not predict development of PCS. Children who developed PCS missed, on average, 7.4 (SD 4.9) days of school.
Conclusions: Children, who were older, had headache on ED presentation and required hospital admission at ED encounter, were at high risk of PCS following TBI. Interventions to identify and begin early treatment for this population may be of benefit to improve outcomes and reduce burden of disease.