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Predictors of Neuropsychological Outcome After Pediatric Concussion

机译：儿科震荡后神经心理结果的预测因素

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Objective: Previous research suggests that neuropsychological outcome after pediatric concussion is determined by unmodifiable, preexisting factors. This study aimed to predict neuropsychological outcome after pediatric concussion by using a sufficiently large sample to explore a vast array of predictors. Method: A total of 311 children and adolescents (6-18 years old) with concussion were assessed in the emergency department to document acute symptomatology and to screen for cognitive functioning. At 4 and 12 weeks postinjury, they completed tests of intellectual functioning, attention/working memory, executive functions, verbal memory, processing speed, and fine motor abilities. Multiple hierarchical logistic and linear regressions were performed to assess the contribution of premorbid factors, acute symptoms, and acute cognitive screening (Standardized Assessment of Concussion-Child) to aspects of neuropsychological outcome: (a) cognitive inefficiency (defined using a modified Neuropsychological Impairment Rule; Beauchamp et al., 2015) and (b) neuropsychological performance (defined using principal component analysis). Results: Neuropsychological impairment was present in 10.3% and 4.5% of participants at 4 and 12 weeks postinjury, respectively. At 4 weeks postinjury, cognitive inefficiency was predicted by premorbid factors and acute cognitive screening, whereas at 12 weeks it was predicted by acute symptoms. Neuropsychological performance at 4 weeks was predicted by a combination of premorbid factors, acute symptoms, and acute cognitive screening, whereas as at 12 weeks, only acute cognitive screening predicted performance. Conclusions: Neuropsychological outcome after pediatric concussion is not attributable solely to preexisting problems but is instead associated with a combination of preexisting and injury-related variables. Acute cognitive screening appears to be particularly useful in predicting neuropsychological status after concussion.
机译：目的：以前的研究表明，儿科震荡后神经心理结果由未经可用预先存在的因素决定。本研究旨在通过使用足够大的样品来预测小儿肠道后的神经心理结果，以探索大量的预测因子。方法：在急诊部门评估急性症状和屏幕上的311名儿童和青少年（6-18岁），并在急性症状和筛选认知功能。在PostInjury 4和12周，他们完成了知识分子功能，注意/工作记忆，执行功能，口头记忆，处理速度和精细电机能力的测试。进行多个层次物流和线性回归以评估前血压因子，急性症状和急性认知筛查（急性认知筛查（标准化评估）对神经心理结果的方面的贡献：（a）认知效率低下（使用改性神经心理学障碍规则定义; Beauchamp等，2015）和（B）神经心理学性能（使用主成分分析定义）。结果：90.3％和4.5％的Postinjury分别在10.3％和4.5％的参与者中出现了神经心理学障碍。在第4周的Postimjury中，通过前膜因素和急性认知筛查预测认知效率效率，而在12周时，急性症状预测。通过前血压因子，急性症状和急性认知筛查的组合预测了4周的神经心理学性能，而截至12周，只有急性认知筛查预测性能。结论：儿科肠道后神经心理学结果仅归因于预先存在的问题，而是与预先存在和伤害相关变量的组合相关。急性认知筛选似乎特别有用于预测震荡后的神经心理学状态。

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