Duration of post‐traumatic amnesia as a predictor of functional outcome in school‐age children: a systematic review

• Published in: Developmental medicine and child neurology 2015-07, Vol.57 (7), p.618-627
• Main Authors: Briggs, Rachel, Brookes, Naomi, Tate, Robyn, Lah, Suncica
• Format: Article
• Language: English
• ISSN: 0012-1622; 1469-8749
• DOI: 10.1111/dmcn.12674

Aim In adults, duration of post‐traumatic amnesia (PTA) is a powerful early predictor of functional outcomes in traumatic brain injury. The aim of this work was to assess the predictive validity of PTA duration for outcomes in children (6–18y). Method PsycINFO, MEDLINE, Web of Science, and Embase were searched for papers published to January 2014. Ten studies met inclusion criteria: they used standardized instruments to assess PTA and functional outcomes, and examined relationships between the two. Outcomes were classified according to (1) the International Classification of Functioning, Disability and Health (ICF) core sets for neurological conditions for post‐acute care and (2) global functioning and quality of life. Methodological quality was rated for each study. Results The search identified 10 studies of moderate mean quality (M=11.8 out of 18). Longer PTA duration related to worse functional outcomes: global functioning and in the two ICF categories (‘body function’, ‘activities and participation’). Relationships between PTA duration and quality of life and the ICF category of ‘body structure’ were not examined. PTA duration was, in 46 out of 60 (76.67%) instances, a stronger predictor of outcomes than other indices of injury severity. Conclusion Longer PTA duration is a valid predictor of worse outcomes in school‐age children. Thus, PTA should be routinely assessed in children after traumatic brain injury. What this paper adds Longer duration of post‐traumatic amnesia (PTA) is related to worse functional outcomes. Duration of PTA better predicted outcomes than Glasgow Coma Scale and length of coma. Duration of PTA did not relate to somatic complaints.