Early versus delayed emergency department presentation following mild Traumatic Brain Injury and the presence of symptom at 1, 4 and 12 weeks in children
| العنوان: | Early versus delayed emergency department presentation following mild Traumatic Brain Injury and the presence of symptom at 1, 4 and 12 weeks in children |
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| المؤلفون: | Keith Owens Yeates, Martin H. Osmond, Emma Burns, William R. Craig, Alexander Sasha Dubrovsky, Kathy Boutis, Gurinder Sangha, Darcy Beer, Ken Tang, Andrée-Ann Ledoux, Jocelyn Gravel, Roger Zemek |
| المصدر: | Paediatrics Publications |
| بيانات النشر: | BMJ, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, Canada, Pediatrics, medicine.medical_specialty, Time Factors, Adolescent, Traumatic brain injury, Poison control, Critical Care and Intensive Care Medicine, Logistic regression, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Concussion, Injury prevention, medicine, paediatric injury, Humans, Prospective Studies, Child, Prospective cohort study, Brain Concussion, 030222 orthopedics, Pediatric Emergency Medicine, business.industry, Head injury, 030229 sport sciences, General Medicine, Emergency department, head, Patient Acceptance of Health Care, medicine.disease, trauma, Logistic Models, Child, Preschool, paediatric emergency med, Emergency Medicine, Female, Emergency Service, Hospital, business |
| الوصف: | ObjectivesWe evaluated the association between timing of presentation and postconcussive symptoms (PCS) at 1, 4 and 12 weeks after injury.MethodsThis was a secondary analysis of a prospective cohort study conducted in nine Canadian paediatric EDs in 2013–2015 (5P study). Participants were children who suffered a head injury within the preceding 48 hours and met Zurich consensus concussion diagnostic criteria. The exposure was the time between head injury and ED presentation. The primary outcome was the presence of PCS at 1 week defined by the presence of at least three symptoms on the Post-Concussion Symptom Inventory (PCSI). Secondary outcomes evaluated PCS at 4 and 12 weeks. Multivariable logistic regression analyses were adjusted for ED PCSI and other potential confounders.ResultsThere were 3041 patients with a concussion in which timing of the injury was known. 2287 (75%) participants sought care in the first 12 hours, 388 (13%) 12–24 hours after trauma and 366 (12%) between 24 and 48 hours. Compared with children who sought care >24 hours after trauma, children who sought care in the first 12 hours had a significantly lower incidence of PCS at 1 week (OR: 0.55 (95% CI 0.41 to 0.75)) and 4 weeks (OR: 0.74 (95% CI 0.56 to 0.99)) but not at 12 weeks (OR: 0.88 (95% CI 0.63 to 1.23)).ConclusionsPatients who present early after a concussion appear to have a shorter duration of PCS than those presenting more than 12 hours later. Patients/families should be informed of the higher probability of PCS in children with delayed presentation. |
| تدمد: | 1472-0213 1472-0205 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b1db731a9f4dc5b1284334270d147613Test https://doi.org/10.1136/emermed-2019-209054Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....b1db731a9f4dc5b1284334270d147613 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14720213 14720205 |
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