Study: Concussion Scoring System May Improve Prediction of Outcomes for Children

Researchers indicate that they have successfully developed a new concussion scoring system that is designed to predict whether children and teens who suffer a head injury are likely to suffer ongoing symptoms that will impact their health and potentially disrupt their lives. 

According to a study published earlier this month in the Journal of the American Medical Association (JAMA), more than one-third of youths who sustain a concussion will experience ongoing acute persistent post-concussion symptoms (PPCS), including headaches, dizziness, difficulty concentrating, change in sleep patterns, and emotional or behavioral changes.

Researchers from the Children’s Hospital of Eastern Ontario Research Institute (CHEO), in Ottawa, Canada, evaluated data on children who have suffered a head injury to come up with a system for determining the likelihood of children experiencing long-term symptoms from concussions.

Concerns about concussions and prolonged symptoms have increased in recent years, as more and more research highlights the potential long-term side effects of head injuries among teens and children, as well as professional athletes.

Each year, U.S. emergency rooms treat 750,000 children with concussions. Prior estimates have suggested that nearly half of those children will end up with long-term headaches from concussions, which may impact them for the rest of their lives.

The study followed more than 3,000 patients between the ages of five and 18, who were treated for a concussion at one of nine pediatric emergency rooms within the Pediatric Emergency Research Canada Network. The children were evaluated within 48 hours of suffering an acute head injury, in many cases within 3 hours, between August 2013 to September 2014 and October 2014 to June 2015. They were then followed up with again 28 days after the injury.

Thirty percent of children ended up with persistent post-concussive symptoms, exhibiting cognitive, psychological and behavioral symptoms, at the 28 day mark.

Researchers focused on 46 possible signs of concussion. After evaluating those they identified children who were more likely to have prolonged symptoms and need closer follow-up.

They created a 12-point scoring system using nine predictors: suffering a prior concussion with symptoms lasting longer than one week, past history of migraines, sensitivity to noise, fatigue, answering questions slowly, age group, gender, cognitive complaints, and four or more errors on the Balance Error Scoring System.

While more boys sustained concussions, girls were twice as likely to have post-concussion symptoms for at least one month. Children under eight years old were less likely to have symptoms than children older than nine.

According to a prior study published in the journal Radiology in 2013, researchers indicated that significant changes to the brain can occur after only one episode of mild traumatic injury, or a typical concussion. So even suffering one prior concussion can be predictive of future symptoms.