5P Risk Classification Predicts Performance on Self-reported but Not Objective Clinical Outcomes at 4 Weeks Postconcussion in Children.

OBJECTIVE

To determine if performance on symptom, cognitive, balance, fatigue, physical activity, and quality of life outcomes at 4 weeks postinjury in children with concussion differs based on acute Predicting and Preventing Postconcussive Problems in Pediatrics (5P) risk classification.

DESIGN

Prospective cohort.

SETTING

Laboratory.

PARTICIPANTS

Sixty-two children (age: 13.27±2.50y; 29 [46.7%] women) with diagnosed concussion.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Patient demographics and postinjury assessments were completed within 72 hours of concussion and used to classify patients as "high," "moderate," or "low" persistent postconcussion symptoms risk. Children then completed a multimodal assessment battery at 4 weeks postconcussion. Kruskal-Wallis assessments analyzed whether study outcomes differed between 5P risk groups.

RESULTS

Significant group differences were observed in symptom (χ2(2)=9.76, P=.008), fatigue (χ2(2)=14.60, P<.001), physical activity (χ2(2)=15.76, P<.001), and quality of life (χ2(2)=7.82, P=.02) outcomes. The low-risk group had fewer symptoms and less fatigue but increased physical activity levels and quality of life compared with the high-risk group. No significant differences in cognitive or balance outcomes were observed (P>.05).

CONCLUSIONS

The 5P rule provides clinicians with valuable prognostic information related to persistent postconcussion symptoms and self-reported outcomes 4 weeks postconcussion, but not objective cognitive or balance outcomes. This information may help clinicians prioritize treatment resources to children most at risk of prolonged concussion recovery.