Postconcussion Symptoms Negatively Impact Pediatric Quality of Life Interview with:

Roger Zemek, MD, FRCPC Associate Professor, Dept of Pediatrics and Emergency Medicine, Clinical Research Chair in Pediatric Concussion, University of Ottawa Director, Clinical Research Unit, Children’s Hospital of Eastern Ontario Ottawa, ON

Dr. Roger Zemek

Roger Zemek, MD, FRCPC
Associate Professor, Dept of Pediatrics and Emergency Medicine, Clinical Research Chair in Pediatric Concussion
University of Ottawa
Director, Clinical Research Unit
Children’s Hospital of Eastern Ontario
Ottawa, ON What is the background for this study?

Response: Concussion remains a major public health concern in children. Approximately 30% of affected children experience persistent post-concussive symptoms (PPCS) for at least one month post-injury. These symptoms may negatively impact their health related quality of life. Examples may include cognition, memory and attention affecting school attendance and performance, mood and social engagement, as well as physical performance. Prior to this study, there was little evidence that examined the relationship between PPCS and quality of life following concussion. This was important to better understand in order to provide appropriate interventions, expectation management and ultimately a better standard of care to affected patients and their families. What are the main findings?

Response: We enrolled 2006 children having met criteria of a concussion in our study, of which 30% experienced PPCS. We found that children with PPCS had a significantly lower total, physical, social, emotional and school functioning quality of life than children without PPCS that persisted for at least 12 weeks post-concussion. Nevertheless, both post-concussive symptoms and non-PPCS patients reported lower total and school quality of life when compared to healthy norms. Finally, we have identified several independent predictors of quality of life decrement, including female sex as well as a personal history of a previous concussion, migraine headache, learning disability, or anxiety disorder. What should readers take away from your report?

Response: Results from our study provide valuable insight into the burden of pediatric concussion. Not only do we show that the presence of PPCS is associated with significant quality of life consequences, but that these deficits are pervasive across all domains and may persist for months (even in those children whose symptoms have resolved). Our study may help identify patients and families requiring extra support or guidance regarding expectation management and coping mechanisms. We believe that it is important to ensure that parents, teachers, school administrators, and educational boards are aware of the potential impact of concussion on children’s quality of life (especially in school). Future interventional research should target improving quality of life following concussion. Thank you for your contribution to the community.


Association of Persistent Postconcussion Symptoms With Pediatric Quality of Life
Zuzana Novak, BSc; Mary Aglipay, MSc; Nick Barrowman, PhD; et al.

JAMA Pediatr. Published online October 24, 2016. doi:10.1001/jamapediatrics.2016.2900

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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