Sport-Related Structural Brain Injury and Return to Play: Systematic Review and Expert Insight.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zuckerman Scott L, Yengo-Kahn Aaron M, Tang Alan R, Bailes Julian E, Beauchamp Kathryn, Berger Mitchel S, Bonfield Christopher M, Camarata Paul J, Cantu Robert C, Davis Gavin A, Ellenbogen Richard G, Ellis Michael J, Feuer Hank, Guazzo Eric, Harris Odette A, Heppner Peter, Honeybul Stephen, Manley Geoff, Maroon Joseph C, Miele Vincent J, Nahed Brian V, Okonkwo David O, Oppenlander Mark E, Petty Jerry, Sabin H Ian, Samadani Uzma, Sherburn Eric W, Sheridan Mark, Tator Charles H, Theodore Nicholas, Timmons Shelly D, Woodworth Graeme F, Solomon Gary S, Sills Allen K
Аннотация
OBJECTIVE: To provide key insight for operative management and RTP following SRSBI using a (1) focused systematic review and (2) survey of expert opinions.
METHODS: A systematic literature review of SRSBI from 2012 to present in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and a cross-sectional survey of RTP in SRSBI by 31 international neurosurgeons was conducted.
RESULTS: Of 27 included articles out of 241 systematically reviewed, 9 (33.0%) case reports provided RTP information for 12 athletes. To assess expert opinion, 31 of 32 neurosurgeons (96.9%) provided survey responses. For acute, asymptomatic SRSBI, 12 (38.7%) would not operate. Of the 19 (61.3%) who would operate, midline shift (63.2%) and hemorrhage size > 10 mm (52.6%) were the most common indications. Following SRSBI with resolved hemorrhage, with or without burr holes, the majority of experts (>75%) allowed RTP to high-contact/collision sports at 6 to 12 mo. Approximately 80% of experts did not endorse RTP to high-contact/collision sports for athletes with persistent hemorrhage. Following craniotomy for SRSBI, 40% to 50% of experts considered RTP at 6 to 12 mo. Linear regression revealed that experts allowed earlier RTP at higher levels of play (β = -0.58, 95% CI -0.111, -0.005, P = .033).
CONCLUSION: RTP decisions following structural brain injury in athletes are markedly heterogeneous. While individualized RTP decisions are critical, aggregated expert opinions from 31 international sports neurosurgeons provide key insight. Level of play was found to be an important consideration in RTP determinations.