Abstract
Objectives
To identify predictors of Persisting Symptoms after Concussion (PSaC) in children, following any medically attended traumatic brain injury (TBI).
Design
Retrospective cohort study
Setting
Linked primary and secondary care data from UK Clinical Practice Research Datalink and Hospital Episode Statistics.
Participants
Children aged 1-17 years with a medically attended TBI between 2013 and 2017.
Main outcome measure
A binary indicator of PSaC or suspected PSaC, measured using either a clinical code for PSaC or medical attendances for one or more PSaC symptoms 3-12 months after TBI.
Results
We identified 137,873 children with a TBI; 4,620 (3.4%) had PSaC or suspected PSaC. More females (3.8%) had PSaC than males (3.1%). Those with PSaC were older at the time of TBI compared with those without PSaC (8 vs 5.5 years). In a multivariable logistic regression model, older age (odds ratio [OR]=1.02 per year increase in age, 95% confidence interval [CI] 1.01-1.03), female sex (OR=1.20, 95% CI 1.13-1.28), being Asian (OR=1.37, 95% CI 1.22-1.54) or mixed ethnicity (OR=1.18, 95% CI 1.01-1.37) (compared with white ethnicity), having a history of headaches (OR=3.52, 95% CI 3.13-3.95), learning disabilities (OR=2.06, 95% CI 1.69-2.52), ADHD (OR=2.41, 95% CI 1.91-3.04), anxiety (OR=2.58, 95% CI 2.18-3.05), depression (OR=4.00, 95% CI 3.28-4.89) or sleep disorders (OR=2.35, 95% CI 1.99-2.78) were associated with increased odds of PSaC.
Conclusions
These results may be used to identify children more likely to develop PSaC following a TBI and those who may benefit from targeted healthcare for PSaC symptoms. Identifying cases of PSaC in primary care data was challenging as perhaps many children do not attend services for suspected PSaC, or, if they did, are not diagnosed with PSaC. Furthermore, the clinical predictors are a measure of healthcare access for these symptoms, thus results could be influenced by patient or carer’s health-seeking behaviour.
To identify predictors of Persisting Symptoms after Concussion (PSaC) in children, following any medically attended traumatic brain injury (TBI).
Design
Retrospective cohort study
Setting
Linked primary and secondary care data from UK Clinical Practice Research Datalink and Hospital Episode Statistics.
Participants
Children aged 1-17 years with a medically attended TBI between 2013 and 2017.
Main outcome measure
A binary indicator of PSaC or suspected PSaC, measured using either a clinical code for PSaC or medical attendances for one or more PSaC symptoms 3-12 months after TBI.
Results
We identified 137,873 children with a TBI; 4,620 (3.4%) had PSaC or suspected PSaC. More females (3.8%) had PSaC than males (3.1%). Those with PSaC were older at the time of TBI compared with those without PSaC (8 vs 5.5 years). In a multivariable logistic regression model, older age (odds ratio [OR]=1.02 per year increase in age, 95% confidence interval [CI] 1.01-1.03), female sex (OR=1.20, 95% CI 1.13-1.28), being Asian (OR=1.37, 95% CI 1.22-1.54) or mixed ethnicity (OR=1.18, 95% CI 1.01-1.37) (compared with white ethnicity), having a history of headaches (OR=3.52, 95% CI 3.13-3.95), learning disabilities (OR=2.06, 95% CI 1.69-2.52), ADHD (OR=2.41, 95% CI 1.91-3.04), anxiety (OR=2.58, 95% CI 2.18-3.05), depression (OR=4.00, 95% CI 3.28-4.89) or sleep disorders (OR=2.35, 95% CI 1.99-2.78) were associated with increased odds of PSaC.
Conclusions
These results may be used to identify children more likely to develop PSaC following a TBI and those who may benefit from targeted healthcare for PSaC symptoms. Identifying cases of PSaC in primary care data was challenging as perhaps many children do not attend services for suspected PSaC, or, if they did, are not diagnosed with PSaC. Furthermore, the clinical predictors are a measure of healthcare access for these symptoms, thus results could be influenced by patient or carer’s health-seeking behaviour.
| Original language | English |
|---|---|
| Article number | e003036 |
| Number of pages | 10 |
| Journal | BMJ Paediatrics Open |
| Volume | 9 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 5 Apr 2025 |
Bibliographical note
Publisher Copyright:© Author(s) (or their employer(s)) 2025.
Research Groups and Themes
- NIHR ARC West