RT Journal Article
SR Electronic
T1 Protocol for a prospective, longitudinal, cohort study of recovery pathways, acute biomarkers and cost for children with persistent postconcussion symptoms: the Take CARe Biomarkers study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e022098
DO 10.1136/bmjopen-2018-022098
VO 9
IS 2
A1 Takagi, Michael
A1 Babl, Franz E
A1 Anderson, Nicholas
A1 Bressan, Silvia
A1 Clarke, Cathriona J
A1 Crichton, Ali
A1 Dalziel, Kim
A1 Davis, Gavin A
A1 Doyle, Melissa
A1 Dunne, Kevin
A1 Godfrey, Celia
A1 Hearps, Stephen J C
A1 Ignjatovic, Vera
A1 Parkin, Georgia
A1 Rausa, Vanessa
A1 Seal, Marc
A1 Thompson, Emma Jane
A1 Truss, Katie
A1 Anderson, Vicki
YR 2019
UL http://bmjopen.bmj.com/content/9/2/e022098.abstract
AB Introduction The majority of children who sustain a concussion will recover quickly, but a significant minority will experience ongoing postconcussive symptoms, known as postconcussion syndrome (PCS). These symptoms include emotional, behavioural, cognitive and physical symptoms and can lead to considerable disability. The neurobiological underpinnings of PCS are poorly understood, limiting potential clinical interventions. As such, patients and families frequently re-present to clinical services, who are often ill equipped to address the multifactorial nature of PCS. This contributes to the high cost of concussion management and the disability of children experiencing PCS. The aims of the present study are: (1) to plot and contrast recovery pathways for children with concussion from time of injury to 3 months postinjury, (ii) evaluate the contribution of acute biomarkers (ie, blood, MRI) to delayed recovery postconcussion and (3) estimate financial costs of child concussion to patients attending the emergency department (ED) of a tertiary children’s hospital and factors predicting high cost.Methods and analysis Take C.A.Re is a prospective, longitudinal study at a tertiary children’s hospital, recruiting and assessing 525 patients aged 5–<18 years (400 concussion, 125 orthopaedic injury) who present to the ED with a concussion and following them at 1–4 days, 2 weeks, 1 month and 3 months postinjury. Multiple domains are assessed: preinjury and postinjury, clinical, MRI, blood samples, neuropsychological, psychological and economic. PCS is defined as the presence of ≥2 symptoms on the Post Concussive Symptoms Inventory rated as worse compared with baseline 1 month postinjury. Main analyses comprise longitudinal Generalised Estimating Equation models and regression analyses of predictors of recovery and factors predicting high economic costs.Ethics and dissemination Ethical approval has been obtained through the Royal Children’s Hospital Melbourne Human Research Ethics Committee (33122). We aim to disseminate the findings through international conferences, international peer-reviewed journals and social media.Trial registration number ACTRN12615000316505; Results.