title: Predicting postconcussion syndrome after mild traumatic brain injury in children and adolescents who present to the emergency department.
abstract: OBJECTIVE
  To determine the acute predictors associated with the development of postconcussion syndrome (PCS) in children and adolescents after mild traumatic brain injury.
  
  
  METHODS
  Retrospective analysis of a prospective observational study.
  
  
  METHODS
  Pediatric emergency department (ED) in a children's hospital.
  
  
  METHODS
  Four hundred six children and adolescents aged 5 to 18 years.
  
  
  METHODS
  Closed head trauma.
  
  
  METHODS
  The Rivermead Post Concussion Symptoms Questionnaire administered 3 months after the injury.
  
  
  RESULTS
  Of the patients presenting to the ED with mild traumatic brain injury, 29.3% developed PCS. The most frequent PCS symptom was headache. Predictors of PCS, while controlling for other factors, were being of adolescent age, headache on presentation to the ED, and admission to the hospital. Patients who developed PCS missed a mean (SD) of 7.4 (13.9) days of school.
  
  
  CONCLUSIONS
  Adolescents who have headache on ED presentation and require hospital admission at the ED encounter are at elevated risk for PCS after mild traumatic brain injury. Interventions to identify this population and begin early treatment may improve outcomes and reduce the burden of disease.
authors.affiliation: Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. lynn.babcock@cchmc.org
authors.forename: Lynn
authors.initials: L
authors.lastname: Babcock
authors.forename: Terri
authors.initials: T
authors.lastname: Byczkowski
authors.forename: Shari L
authors.initials: SL
authors.lastname: Wade
authors.forename: Mona
authors.initials: M
authors.lastname: Ho
authors.forename: Sohug
authors.initials: S
authors.lastname: Mookerjee
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Bazarian
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000150:complications / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D016489:Head Injuries, Closed / Q000150:complications / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D038223:Post-Concussion Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires