Concussion severity and functional outcome using biomarkers in children and youth involved in organized sports, recreational activities and non-sport related incidents.

Autor:	Papa L; Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida, USA.; Department of Pediatric Emergency Medicine, Arnold Palmer Hospital for Children, Orlando, Florida, USA., Rosenthal K; College of Medicine, University of Florida, Orlando, Florida, USA., Cook L; Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida, USA., Caire M; Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida, USA., Thundiyil JG; Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida, USA.; Department of Pediatric Emergency Medicine, Arnold Palmer Hospital for Children, Orlando, Florida, USA., Ladde JG; Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida, USA.; Department of Pediatric Emergency Medicine, Arnold Palmer Hospital for Children, Orlando, Florida, USA., Garfinkel A; College of Medicine, California North state University, Elk Grove, California, USA., Braga CF; Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida, USA., Tan CN; Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida, USA., Ameli NJ; Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida, USA., Lopez MA; Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida, USA., Haeussler CA; Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida, USA., Mendez Giordano D; Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida, USA., Giordano PA; Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida, USA.; Department of Pediatric Emergency Medicine, Arnold Palmer Hospital for Children, Orlando, Florida, USA., Ramirez J; Department of Pediatric Emergency Medicine, Arnold Palmer Hospital for Children, Orlando, Florida, USA., Mittal MK; Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Zonfrillo MR; Department of Emergency Medicine, Alpert Medical School of Brown University and Hasbro Children's Hospital, Providence, Rhode Island, USA.
Jazyk:	angličtina
Zdroj:	Brain injury [Brain Inj] 2022 Jul 03; Vol. 36 (8), pp. 939-947. Date of Electronic Publication: 2022 Jul 29.
DOI:	10.1080/02699052.2022.2106383
Abstrakt:	This prospective multicenter study evaluated differences in concussion severity and functional outcome using glial and neuronal biomarkers glial Fibrillary Acidic (GFAP) and Ubiquitin C-terminal Hydrolase (UCH-L1) in children and youth involved in non-sport related trauma, organized sports, and recreational activities. Children and youth presenting to three Level 1 trauma centersfollowing blunt head trauma with a GCS 15 with a verified diagnosis of a concussion were enrolled within 6 hours of injury. Traumatic intracranial lesions on CT scan and functional outcome within 3 months of injury were evaluated. 131 children and youth with concussion were enrolled, 81 in the no sports group, 22 in the organized sports group and 28 in the recreational activities group. Median GFAP levels were 0.18, 0.07, and 0.39 ng/mL in the respective groups (p = 0.014). Median UCH-L1 levels were 0.18, 0.27, and 0.32 ng/mL respectively (p = 0.025). A CT scan of the head was performed in 110 (84%) patients. CT was positive in 5 (7%), 4 (27%), and 5 (20%) patients, respectively. The AUC for GFAP for detecting +CT was 0.84 (95%CI 0.75-0.93) and for UCH-L1 was 0.82 (95%CI 0.71-0.94). In those without CT lesions, elevations in UCH-L1 were significantly associated with unfavorable 3-month outcome. Concussions in the 3 groups were of similar severity and functional outcome. GFAP and UCH-L1 were both associated with severity of concussion and intracranial lesions, with the most elevated concentrations in recreational activities .
Databáze:	MEDLINE
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