RT Journal
A1 Zemek RL, Farion KJ, Sampson M,  McGahern C
T1 Prognosticators of persistent symptoms following pediatric concussion: A systematic review
JF JAMA Pediatrics
JO JAMA Pediatrics
YR 2013
FD March 1
VO 167
IS 3
SP 259
OP 265
DO 10.1001/2013.jamapediatrics.216
UL http://dx.doi.org/10.1001/2013.jamapediatrics.216
AB Objective 
                  To identify predictors of persistent concussion symptoms (PCS) in children following concussion.Data Sources 
                  We searched MEDLINE, Embase, and the Cochrane Library to April 2012.Study Selection 
                  A systematic review of the literature to identify prognosticators of PCS following pediatric concussion was conducted. Studies evaluating patients aged 2 years to 18 years with PCS were eligible.Main Outcome Measures 
                  The association of clinically available factors with PCS development.Results 
                  A literature search yielded 824 records; 561 remained after removal of duplicates. Fifteen studies were included in descriptive analysis; heterogeneity precluded a meta-analysis. Larger prospective studies concluded that the risk for PCS was increased in older children with loss of consciousness, headache, and/or nausea/vomiting. Smaller studies noted that initial dizziness may predict PCS. Patients with premorbid conditions (eg, previous head injury, learning difficulties, or behavioral problems) may also have increased risk.Conclusions 
                  Minimal, and at times contradictory, evidence exists to associate clinically available factors with eventual development of PCS in children. Future trials must be adequately powered to determine which variables best predict the time to full symptom resolution. Expert consensus should delineate which postconcussion assessment measures are preferred to reduce heterogeneity going forward. Research to improve care for the epidemic of pediatric concussion depends on early identification of those most in need of intervention.