R O G E R Z E M E K , M D , F R C P C

C H I L D R E N ’ S H O S P I TA L O F E A S T E R N O N TA R I O

M A R T I N O S M O N D , M D , F R C P C

C H I L D R E N ’ S H O S P I TA L O F E A S T E R N O N TA R I O

5P: Predicting and Preventing Postconcussive Problems in Pediatrics

What are key accomplishments in the past year?

IWK Health Sciences Centre

CHU Sainte-Justine Montreal Children’ s HospitalChildren’ s Hospital of Eastern Ontario

The Hospital for Sick ChildrenChildren’ s Hospital of Western Ontario

Children’ s Hospital of Winnipeg

Stollery Children’ s HospitalAlberta Children’ s Hospital

12

3

45

6

78

9

Not Eligible (n=1681)Eligible but cannot complete follow-up (n=34)Missing eligibility (n=52)   

 Eligible Patients (n=2199)

Consented (n=1708)English: (n=1468)French: (n=240)

Withdrew (n=68) Baseline (n=1640)

1 week follow-up (n=1408)

8 weeks follow-up (n=1089)

2 weeks follow-up (n=1335)

4 weeks follow-up (n=1245)

12 weeks follow-up (n=893)

Screened (n=3966)

Did not consent (n=479)1

Declined participation (n=434) RA not available to consent family

(n=43) Missing reason for non-consent (n=2)Missing Consent (n=12) 

1 week follow-up not yet due (n=34); 87% rate

2 weeks follow-up not yet due (n=78); 85% rate

4 weeks follow-up not yet due (n=168); 85% rate  

12 weeks follow-up not yet due (n=482); 77% rate  

8 weeks follow-up not yet due (n=304); 82% rate  

Baseline Characteristics

Characteristic Patients (n=1640)

Age (mean (SD)) 11.7 (3.4)

Female (%) 624 (38.0)

Previous number of concussions  

0 1235 (75.3)

1 238 (14.5)

2 89 (5.4)

3 35 (2.1)

4 11 (0.7)

5 4 (0.2)

6 or more 5 (0.3)

Baseline Characteristics (continued)

Characteristic Patients (n=1640)

Longest symptom duration of previous concussion  

Less than 1 week 159 (9.7)

1-2 weeks 90 (5.5)

3-4 weeks 58 (3.5)

5-8 weeks 24 (1.5)

8 weeks or more 46 (2.8)

Migraine 201 (12.4)

Family history of migraine 763 (46.5)

Learning disabilities 146 (8.9)

ADD/ ADHD 161 (9.8)

What are the major challenges or issues, if any?

Organizing neuropsychological testing English and French testing materials Possible bias to those still symptomatic

Contracts/Ethics at 9 hospitals Some delays up to 7 months

What percentage of your data is comprised of the International TBI Common Data Elements and what percentage are unique data elements?

100% overlap with Pediatric Concussion/mTBI data elements for acute setting (Isabelle Gagnon)PCSI (5-7, 8-12, 13-18)

95-99% overlap with International TBI CDE Unique to pediatric concussion

Child SCAT3 elements: BESS, cognitive screen