Influence of Personal and Injury-Related Factors Predicting Deficits in Quality of Life Domains Among Pediatric Athletes: Findings From the Sport Concussion Outcomes in Pediatrics Study

Variables associated with days of school missed following concussion: results from the Sport Concussion Outcomes in PEdiatrics (SCOPE) study

OBJECTIVE

To understand factors associated with missed academic time after concussion to improve support for patients. Our goal was to assess patient-specific predictors of total school time lost after pediatric/adolescent concussion.

STUDY DESIGN

We performed a prospective cohort study of children and adolescents (8-18 years of age) seen within 14 days of concussion from seven pediatric medical centers across the United States. We collected outcomes via the Concussion Learning Assessment & School Survey (CLASS) and constructed a multivariable predictive model evaluating patient factors associated with school time loss.

RESULTS

167 patients participated (mean age = 14.5 ± 2.2 years; 46% female). Patients were assessed initially at 5.0 ± 3.0 days post-injury and had a final follow-up assessment 24.5 ± 20.0 days post-concussion. Participants missed a median of 2 days of school (IQR = 0.5-4), and 21% reported their grades dropped after concussion. Higher initial symptom severity rating (β = 0.06, 95% CI = 0.03-0.08, p < 0.001) and perception of grades dropping after concussion (β = 1.37, 95% CI = 0.28-2.45, p = 0.01) were significantly associated with more days of school time missed after concussion. Those who reported their grades dropping reported missing significantly more school (mean = 5.0, SD = 4.7 days missed of school) than those who reported their grades did not drop (mean = 2.2, SD = 2.6 days missed of school; p < 0.001; Cohen's d = 0.87).

CONCLUSIONS

Children and adolescents reported missing a median of 2 days of school following concussion, and more missed school time after a concussion was associated with more severe concussion symptoms and perception of grades dropping. These findings may support recommendations for minimal delays in return-to-learn after concussion.

Factors Associated with Deterioration in Quality of Life of Subjects after Maxillofacial Fractures - A Prospective Study

Introduction

Maxillofacial fractures (MFs) are quite common and are managed by oral and maxillofacial surgeons. Despite these interventions, a pre-traumatic facial profile is often not achieved with consequent social and psychologic consequences.

Materials and Methods

Patients with fractures to the middle and lower third of the face that presented within 48 hours and healthy controls (subjects without facial fracture) that were sex- and age-matched with the fracture patients were recruited into the study. World Health Organization Quality of Life - Brief Version (WHOQOL-BREF) questionnaire was used to compare the Quality of Life (QoL) values according to age, gender, educational status, employment status, marital status, site of trauma and type of fracture.

Results

Only the age of subjects was associated with deterioration in QoL after MF while other variables were not.

Discussion

Increasing age of the patients was associated with higher QoL possibly because those with age <30 years are single and unemployed and may have fear and anxiety that the fracture could affect their chances of getting married or being employed, causing reduced QoL. Psychosocial rehabilitation is very important in patients with MF, especially for the young age group.