Factors related to adverse long-term outcomes after mild traumatic brain injury in children: A scoping review

Sharea Ijaz*, Jelena Savović, Lauren J Scott, Sarah Dawson, Rebecca Wilson, Maria Theresa Redaniel, Joni Jackson, Kate Birnie, Julie Mytton, Mark D Lyttle

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)


Objective: To identify demographic, premorbid and injury-related factors, or biomarkers associated with long-term (≥3 months) adverse outcomes in children after mild traumatic brain injury (mTBI).
Design: Scoping review of literature
Patients: Children and adolescents with mTBI
Risk factors: Any demographic, premorbid and injury-related factors, or biomarkers were included. We excluded genetic and treatment-related factors.
Main outcome measures: post-concussion syndrome (PCS), recovery.
Results: Seventy-three publications were included, reporting twelve long-term adverse outcomes, including PCS in 12 studies, and recovery in 29 studies. Additional outcomes studied were symptom scores/severity (n=22), quality of life (n=9) and cognitive function (n=9). Forty-nine risk factors were identified across studies. Risk factors most often assessed were sex (n=28), followed by age (n=23), injury mechanism = (n=22), and prior mTBI (n=18). The influence of these and other risk factors on outcomes of mTBI were inconsistent across the reviewed literature.
Conclusions: The most researched risk factors are sex, age, and mechanism of injury, but their effects have been estimated inconsistently and did not show a clear pattern. The most studied outcomes are recovery patterns and symptom severity. However, these may not be the most important outcomes for clinicians and patients. Future primary studies in this area should focus on patient-important outcomes. Population-based prospective studies are needed that address pre-specified hypotheses on the relationship of risk factors with given outcomes to enable reliable prediction of long-term adverse outcomes for childhood mTBI.

Original languageEnglish
Article numberarchdischild-2022-325202
Pages (from-to)492-497
Number of pages6
JournalArchives of Disease in Childhood
Issue number6
Early online date31 Mar 2023
Publication statusPublished - 18 May 2023

Bibliographical note

Funding Information:
This work was funded by the The National Institute for Health and Care Research (NIHR) Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston National Health Service (NHS) Foundation Trust.

Funding Information:
SI, LS, RW, SD, JJ, MTR, and JS report grant funding from NIHR (NIHR ARC West) during the conduct of the study. JS reports personal fees from Core Models Limited, UK (for teaching introductory systematic review methods at an online course), unrelated to the submitted work.

Publisher Copyright:
© 2023 BMJ Publishing Group. All rights reserved.


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