New Concussion Score for Children Flags Higher-Risk Cases
Written by Editor   
Friday, April 15, 2016 12:00 AM

A 12-point clinical score for children with concussion has been developed and shown in a new study to identify those who are more likely to have prolonged symptoms and therefore need closer follow-up.

Concussion has received a fair amount of media attention recently, which has resulted in rising numbers of visits to the emergency department and primary care doctors. "The first question parents ask is, 'When is my child going to be better?' But prior to this work we didn't have any scientific basis to answer this question." 

Concussion symptoms are prolonged for more than a month in about one third of cases. Such symptoms can include headache, dizziness, and difficulty concentrating, symptoms that have an adverse effect on quality of life and can affect school attendance and exam performance.

The researchers of this study looked at more than 70 possible variables and found 9 that seemed to be particularly independently associated with long-term symptoms: female sex, age 13 years or older, migraine history, previous concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and difficulty standing on a balance beam (4 or more errors on the Balance Error Scoring System).

"Interestingly, some of the traditional risks factors that have caused concern, such as vomiting and loss of consciousness, didn't make the final round when we assessed all the risk factors together."

The researchers developed a scoring system; most of these factors were assigned 1 point, but age 13 or older , female sex, and fatigue were given 2 points because they were more strongly associated with long-term symptoms. This resulted in a 12-point scale, and the researchers designated a score of 9 to 12 as high risk, 0 to 3 as low risk, and 4 to 8 as intermediate risk.  

"Our results suggest that a score of 9 to 12 on this scale signifies a high risk of prolonged symptoms of concussion, with a 93% certainty: ie, the test has a 93% specificity. We can also say that a score of 9 to 12 means that a child is three times more likely to have persistent symptoms than the standard score. And a score of 0 to 3 means they are three times less likely than a standard score to have prolonged issues."