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Title: Characteristics of concussion based on patient age and sex: a multicenter prospective observational study.
Austin Authors: Babl, Franz E;Rausa, Vanessa C;Borland, Meredith L;Kochar, Amit;Lyttle, Mark D;Phillips, Natalie;Gilhotra, Yuri;Dalton, Sarah;Cheek, John A;Furyk, Jeremy;Neutze, Jocelyn;Bressan, Silvia;Davis, Gavin A ;Anderson, Vicki;Williams, Amanda;Oakley, Ed;Dalziel, Stuart R;Crowe, Louise M;Hearps, Stephen J C
Affiliation: Departments of Surgery and Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
Emergency Department, Kidzfirst Middlemore Hospital, Auckland, New Zealand
Faculty of Health & Life Sciences, University of the West of England, Bristol, United Kingdom
Emergency Department, Starship Children's Health, Auckland
Clinical Sciences, Murdoch Children's Research Institute, Melbourne
Department of Women's and Children's Health, University of Padova, Padova, Italy
Department of Neurosurgery, Austin and Cabrini Hospitals, Melbourne
School of Psychological Sciences, University of Melbourne, Melbourne
Psychology Service, Royal Children's Hospital, Melbourne
Emergency Department, Royal Children's Hospital, Melbourne
Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne
Emergency Department, Monash Medical Centre, Melbourne, Australia
Emergency Department, The Townsville Hospital, Townsville, Queensland
School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
Emergency Department, The Children's Hospital at Westmead, Sydney
Emergency Department, Women's & Children's Hospital, Adelaide, Australia
Emergency Department, Perth Children's Hospital, Perth, Australia
School of Medicine, Divisions of Emergency Medicine and Paediatrics, University of Western Australia, Perth, Australia
Emergency Department, Queensland Children's Hospital, Brisbane
Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane
Issue Date: 1-Oct-2021
Date: 2021-10-01
Publication information: Journal of Neurosurgery. Pediatrics 2021; online first: 1 October
Abstract: Children with concussion frequently present to emergency departments (EDs). There is limited understanding of the differences in signs, symptoms, and epidemiology of concussion based on patient age. Here, the authors set out to assess the association between age and acute concussion presentations. The authors conducted a multicenter prospective observational study of head injuries at 10 EDs in Australia and New Zealand. They identified children aged 5 to < 18 years, presenting with a Glasgow Coma Scale score of 13-15, presenting < 24 hours postinjury, with no abnormalities on CT if performed, and one or more signs or symptoms of concussion. They extracted demographic, injury-related, and signs and symptoms information and stratified it by age group (5-8, 9-12, 13 to < 18 years). Of 8857 children aged 5 to < 18 years, 4709 patients met the defined concussion criteria (5-8 years, n = 1546; 9-12 years, n = 1617; 13 to < 18 years, n = 1546). The mean age of the cohort was 10.9 years, and approximately 70% of the patients were male. Sport-related concussion accounted for 43.7% of concussions overall, increasing from 19.1% to 48.9% to 63.0% in the 5-8, 9-12, and 13 to < 18 years age groups. The most common acute symptoms postinjury were headache (64.6%), disorientation (36.2%), amnesia (30.0%), and vomiting (27.2%). Vomiting decreased with increasing age and was observed in 41.7% of the 5-8 years group, 24.7% of the 9-12 years group, and 15.4% of the 13 to < 18 years group, whereas reported loss of consciousness (LOC) increased with increasing age, occurring in 9.6% in the 5-8 years group, 21.0% in the 9-12 years group, 36.7% in the 13 to < 18 years group, and 22.4% in the entire study cohort. Headache, amnesia, and disorientation followed the latter trajectory. Symptom profiles were broadly similar between males and females. Concussions presenting to EDs were more sports-related as age increased. Signs and symptoms differed markedly across age groups, with vomiting decreasing and headache, LOC, amnesia, and disorientation increasing with increasing age.
DOI: 10.3171/2021.6.PEDS20953
Journal: Journal of Neurosurgery. Pediatrics
PubMed URL: 34598158
Type: Journal Article
Subjects: concussion
emergency department
Appears in Collections:Journal articles

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