TY  - JOUR
PY  - 2024//
TI  - Postconcussive symptoms after early childhood concussion
JO  - JAMA network open
A1  - Dupont, Dominique
A1  - Tang, Ken
A1  - Beaudoin, Cindy
A1  - Dégeilh, Fanny
A1  - Gagnon, Isabelle
A1  - Yeates, Keith Owen
A1  - Rose, Sean C.
A1  - Gravel, Jocelyn
A1  - Burstein, Brett
A1  - Stang, Antonia S.
A1  - Stanley, Rachel M.
A1  - Zemek, Roger L.
A1  - Beauchamp, Miriam H.
SP  - e243182
EP  - e243182
VL  - 7
IS  - 3
N2  - IMPORTANCE: Research 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. <br><br>OBJECTIVE: To document PCS in the first 3 months after early childhood concussion using a developmentally appropriate measure. DESIGN, SETTING, AND PARTICIPANTS: This 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. EXPOSURE: Concussion sustained between ages 6 and 72 months. MAIN OUTCOMES AND MEASURES: Primary 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 & Symptoms inventory. Group comparisons were analyzed using ordinal regression models. <br><br>RESULTS: The 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. <br><br>CONCLUSIONS AND RELEVANCE: In 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.<p />  <p>Language: en</p>
LA  - en
SN  - 2574-3805
UR  - http://dx.doi.org/10.1001/jamanetworkopen.2024.3182
ID  - ref1
ER  -