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Title: Protocol for a prospective, longitudinal, cohort study of recovery pathways, acute biomarkers and cost for children with persistent postconcussion symptoms: the Take CARe Biomarkers study.
Austin Authors: Takagi, Michael;Babl, Franz E;Anderson, Nicholas;Bressan, Silvia;Clarke, Cathriona J;Crichton, Ali;Dalziel, Kim;Davis, Gavin A ;Doyle, Melissa;Dunne, Kevin;Godfrey, Celia;Hearps, Stephen J C;Ignjatovic, Vera;Parkin, Georgia;Rausa, Vanessa;Seal, Marc;Thompson, Emma Jane;Truss, Katie;Anderson, Vicki
Affiliation: Department of Paediatrics, University of Melbourne, Carlton, Victoria, Australia
Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
Department of Women's and Children's Health, University of Padova, Padova, Italy
Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia
Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
Psychology Service, Royal Childrens Hospital, Melbourne, Victoria, Australia
Department of Rehabilitation Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
Department of Neurosurgery, Cabrini Hospitals, Parkville, Victoria, Australia
Department of Neurosurgery, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 24-Feb-2019
Date: 2019-02-24
Publication information: BMJ Open 2019; 9(2): e022098
Abstract: The majority of children who sustain a concussion will recover quickly, but a significant minority will experience ongoing postconcussive symptoms, known as postconcussion syndrome (PCS). These symptoms include emotional, behavioural, cognitive and physical symptoms and can lead to considerable disability. The neurobiological underpinnings of PCS are poorly understood, limiting potential clinical interventions. As such, patients and families frequently re-present to clinical services, who are often ill equipped to address the multifactorial nature of PCS. This contributes to the high cost of concussion management and the disability of children experiencing PCS. The aims of the present study are: (1) to plot and contrast recovery pathways for children with concussion from time of injury to 3 months postinjury, (ii) evaluate the contribution of acute biomarkers (ie, blood, MRI) to delayed recovery postconcussion and (3) estimate financial costs of child concussion to patients attending the emergency department (ED) of a tertiary children's hospital and factors predicting high cost. Take C.A.Re is a prospective, longitudinal study at a tertiary children's hospital, recruiting and assessing 525 patients aged 5-<18 years (400 concussion, 125 orthopaedic injury) who present to the ED with a concussion and following them at 1-4 days, 2 weeks, 1 month and 3 months postinjury. Multiple domains are assessed: preinjury and postinjury, clinical, MRI, blood samples, neuropsychological, psychological and economic. PCS is defined as the presence of ≥2 symptoms on the Post Concussive Symptoms Inventory rated as worse compared with baseline 1 month postinjury. Main analyses comprise longitudinal Generalised Estimating Equation models and regression analyses of predictors of recovery and factors predicting high economic costs. Ethical approval has been obtained through the Royal Children's Hospital Melbourne Human Research Ethics Committee (33122). We aim to disseminate the findings through international conferences, international peer-reviewed journals and social media. ACTRN12615000316505; Results.
DOI: 10.1136/bmjopen-2018-022098
ORCID: 0000-0002-1107-2187
Journal: BMJ Open
PubMed URL: 30804026
Type: Journal Article
Subjects: haematology
health economics
Magnetic Resonance Imaging
neurological injury
Appears in Collections:Journal articles

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