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Title: Use of the sport concussion assessment tools in the emergency department to predict persistent post-concussive symptoms in children.
Austin Authors: Bressan, Silvia;Clarke, Cathriona J;Anderson, Vicki;Takagi, Michael;Hearps, Stephen J C;Rausa, Vanessa;Anderson, Nicholas;Doyle, Melissa;Dunne, Kevin;Oakley, Ed;Davis, Gavin A ;Babl, Franz E
Affiliation: Department of Neurosurgery, Cabrini Hospital, Melbourne, Victoria, Australia
Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
Department of Women's and Children's Health, University of Padova, Padova, Italy
Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia
Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
Department of Rehabilitation Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
Psychology Department, Royal Children's Hospital, Melbourne, Victoria, Australia
Department of Neurosurgery, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Aug-2020 2020-05-21
Publication information: Journal of paediatrics and child health 2020; 56(8): 1249-1256
Abstract: The Sport Concussion Assessment Tool v3 (SCAT3) and its child version (ChildSCAT3) are composite tools including a symptom scale, a rapid cognitive assessment (standardised assessment of concussion (SAC)) and the modified Balance Error Scoring System (mBESS). It is unclear whether their use for the acute assessment of paediatric concussion in the emergency department (ED) may help predict persistent post-concussive symptoms (PPCS). We aim to assess the predictive value of the main SCAT3/ChildSCAT3 components for PPCS when applied in the ED. A single-site, prospective longitudinal cohort study of children aged 5-18 years assessed within 48 h of their concussion at the ED of a state-wide tertiary paediatric hospital and followed up at the affiliated concussion clinic, between November 2013 and August 2017. PPCS was defined as ≥2 new or worsening symptoms at 1 month post-injury using the Post-Concussive Symptom Inventory. Of the 370 children enrolled, 213 (57.7% <13 years old) provided complete data. Of these, 34.7% had PPCS at 1 month post-injury (38.2% of children <13 years and 30.0% ≥13 years of age, P = 0.272). The adjusted ORs from multiple logistic regression models, for number and severity of symptoms, and for the SAC and mBESS performance in both the ChildSCAT3/SCAT3, were all not significant. The area under the curve of receiver operator characteristic curves for all analysed ChildSCAT3/SCAT3 components was below 0.6. Although SCAT3 and ChildSCAT3 are recommended tools to assist with concussion diagnosis and monitoring of patient recovery, their use in the ED does not seem to help predict PPCS.
DOI: 10.1111/jpc.14910
ORCID: 0000-0002-1107-2187
PubMed URL: 32436608
Type: Journal Article
Subjects: SCAT
emergency department
mild traumatic brain injury
post-concussive symptom
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