Prevalence of post-concussion-like symptoms in children and adolescents in Germany: a cross-sectional study.

BACKGROUND

Pediatric traumatic brain injury (TBI) is a major cause of disability and long-term sequelae in children and adolescents worldwide. To facilitate understanding of the emotional, cognitive, and somatic symptoms following pediatric TBI, the present study aims to assess the prevalence of post-concussion-like symptoms (PCLS) in children and adolescents aged 8 to 17 years in Germany and to investigate the associations between risk factors and the occurrence of symptoms.

METHODS

A web-based survey included two age-appropriate versions of the Postconcussion Symptom Inventory (PCSI; for children: 8–12 years, for adolescents: 13–17 years), a self-report questionnaire recommended for post-concussion symptom assessment in young patients. Classification of participants according to symptom impairment occurred using different cut-offs. We used logistic regression to examine the influence of sociodemographic and health-related factors.

RESULTS

A total of 1.997 respondents completed the survey. The most commonly reported symptom in the 8–12 age group was irritability (49.8%) and in the 13–17 age group drowsiness (51.6%). More than half (58.3%) of children and up to 66.5% of adolescents were classified as impaired despite not having experienced TBI, using the most liberal cut-off score that considered impairment if at least three PCSI symptoms indicated at least a mild problem. Chronic health conditions were found to be a significant risk factor for reporting impairment.

CONCLUSIONS

We found a high prevalence of PCLS in children and adolescents from the general German population, suggesting that these symptoms are not exclusively TBI-specific. Therefore, the evaluation of post-concussion symptoms after TBI should be done with caution, taking into account the individual’s premorbid health status and medical history. TRIAL REGISTRATION: The study is registered retrospectively in German Clinical Trials Register and in International Clinical Trials Registry Platform (DRKS00032854||12/10/2023).