Looking at outcomes a year after concussion

The understanding of concussion and what is needed to effectively treat it without the risk of long-term effects has changed in recent years. A report in the Journal of Pediatrics looks at how children are doing a year following an acute concussion as well as those who had subsequent repeat concussions.¹

The investigators ran a secondary analysis of the Predicting Persistent Postconcussive Problems in Pediatrics study, which was run in 9 emergency departments in Canada. The participants in the study were children aged 5 to 18 years who presented ≤48 consecutive hours of concussion and also agreed to complete a post hoc survey a year after the injury. A standardized 25-question symptom scale was used to assess outcomes.

A total of 432 children from the study completed the 1-year survey and 34 of them indicated a repeat concussion. After an acute concussion, children or adolescents were more likely to be symptom free than after a repeat concussion (75% vs 50%; difference = 25% [95% CI 8-41]; P = .002) as well as to have a full recovery (90% vs 74%; difference = 17% [95% CI 5-34]; P = .002) after 1 year. Physical symptoms had lessened in the year following the concussion for both groups, but those with a repeat concussion indicated greater persistence of headaches (26% vs 13%; difference = 13% [95% CI 1,31]; P = .024). Both groups were also able to return to a normal school routine (100% vs 95%; difference = 5% [95% CI −5 to 8; P = .618]), but those who did not have a repeat concussion were found to more frequently return to sports (95% vs 82%; difference = 13% [95% CI 3-29]; P = .009) and normal physical activity (98% vs 85%; difference = 13% [95% CI 4-28]; P < .0001).

The researchers concluded that most children and adolescents who have a concussion are fully recovered as well as symptom-free after 1 year. However, a repeat concussion could lead to delays in returning to normal routines and could lead to non-optimal outcomes.

Reference

1. van Ierssel J, Ledoux A, Tang K, et al. Symptom burden, school function, and physical activity one year following pediatric concussion. J Pediatr. 2021;228:190-198.e3. doi:10.1016/j.jpeds.2020.08.061