Psychosocial Consequences of Mild Traumatic Brain Injury in Children: Results of a Systematic Review by the International Collaboration on Mild Traumatic Brain Injury Prognosis
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文摘
To synthesize the best available evidence regarding psychosocial consequences of mild traumatic brain injury (MTBI) in children.

<h4 id="absSec_2">Data Sourcesh4>

spara0015">MEDLINE, Embase, CINAHL, PsycINFO, and SPORTDiscus were searched (2001&ndash;2012). Inclusion criteria included published peer-reviewed reports in English, French, Norwegian, Spanish, Swedish, and Danish. References were also identified from relevant reviews and meta-analyses, and the bibliographies of eligible articles.

<h4 id="absSec_3">Study Selectionh4>

spara0020">This article presents an update of a previous review with a much larger scope, of which this topic is a small subset of the questions addressed by that review. Controlled trials and cohort and case-control studies were selected according to predefined criteria. Two independent reviewers used modified Scottish Intercollegiate Guidelines Network criteria to critically appraise eligible studies. A total of 77,914 records were screened; 101 of these articles were deemed scientifically admissible, of which 6 investigated the psychosocial consequences of MTBI in children.

<h4 id="absSec_4">Data Extractionh4>

spara0025">Two reviewers independently extracted data from accepted studies into evidence tables.

<h4 id="absSec_5">Data Synthesish4>

spara0030">We conducted a best-evidence synthesis by linking our conclusions to the evidence tables. Most accepted studies were exploratory rather than confirmatory. Preliminary evidence suggests that most children recover within 3 months post-MTBI. After 1 year, the prevalence of postconcussion symptoms and syndrome is similar between children with MTBI and children with orthopedic injuries. The functional status of children with MTBI improves over a 30-month follow-up period, but further research is needed to investigate the possibility that children with MTBI experience greater rates of psychiatric illness during the 3 years after their injury.

<h4 id="absSec_6">Conclusionsh4>

spara0035">The prognosis of MTBI is favorable in children. Most appear to recover functionally from a physical and psychological perspective. However, future research should investigate the risk for psychiatric illness.

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