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Depending on diagnostic criteria, 13 to 62% of those patients develop persistent post-concussion symptoms (PPCS). The main objective of this prospective multi-center study is to derive and validate a clinical decision rule (CDR) for the early prediction of PPCS. Patients aged \u226514 years were included if they presented to one of our seven participating emergency departments (EDs) within 24\u2009h of an mTBI. Clinical data were collected in the ED, and symptom evolution was assessed at 7, 30 and 90 days post-injury using the Rivermead Post-Concussion Questionnaire (RPQ). The primary outcome was PPCS at 90 days after mTBI. A predictive model called the Post-Concussion Symptoms Rule (PoCS Rule) was developed using the methodological standards for CDR. Of the 1083 analyzed patients (471 and 612 for the derivation and validation cohorts, respectively), 15.6% had PPCS. The final model included the following factors assessed in the ED: age, sex, history of prior TBI or mental health disorder, headache in ED, cervical sprain and hemorrhage on computed tomography. The 7-day follow-up identified additional risk factors: headaches, sleep disturbance, fatigue, sensitivity to light, and RPQ \u226521. The PoCS Rule had a sensitivity of 91.4% and 89.6%, a specificity of 53.8% and 44.7% and a negative predictive value of 97.2% and 95.8% in the derivation and validation cohorts, respectively. The PoCS Rule will help emergency physicians quickly stratify the risk of PPCS in mTBI patients and better plan post-discharge resources.<\/jats:p>","DOI":"10.1089\/neu.2022.0026","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T03:46:56Z","timestamp":1656474416000},"page":"1349-1362","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":33,"title":["Post-Concussion Symptoms Rule: Derivation and Validation of a Clinical Decision Rule for Early Prediction of Persistent Symptoms after a Mild Traumatic Brain Injury"],"prefix":"10.1177","volume":"39","author":[{"given":"Natalie","family":"Le Sage","sequence":"first","affiliation":[{"name":"CHU de Qu\u00e9bec-Universit\u00e9 Laval Research Centre, Universit\u00e9 Laval, Qu\u00e9bec, Canada."},{"name":"VITAM-Centre de recherche en sant\u00e9 durable, Universit\u00e9 Laval, Qu\u00e9bec, 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