Keywords

brain, concussion, injury, mild, prediction, traumatic

 

Authors

  1. Sheedy, Joanne BPsych
  2. Harvey, Evelyn BSc Psych, MClin Neuropsychology
  3. Faux, Steven MBBS, BA, FRACGP, FAFRM (RACP), FFPMANZCA
  4. Geffen, Gina PhD, FASSA, FAPsS
  5. Shores, E. Arthur MA, PhD

Abstract

Objective: To investigate the utility of a brief emergency department (ED) bedside screen for the prediction of postconcussive symptoms at 3 months following mild traumatic brain injury (MTBI).

 

Participants: One hundred patients with MTBI (78% men; mean age = 33.6 years); 2 control groups (each n = 100), a "minor nonhead injury" group (77% men; mean age = 32.2 years) and an "uninjured ED visitor" group (78% men; mean age = 33.6 years).

 

Main Measures: Brief measures of neuropsychological functioning, acute pain, and postural stability were collected in the ED; telephone follow-up at 3 months using the Rivermead Post-Concussion Symptoms Questionnaire was undertaken.

 

Results: Neuropsychological deficits, acute pain, and postural instability in the ED were significantly associated with postconcussive symptoms at 3-month follow-up. A regression formula using 3 easily obtainable measures obtained during acute stage of injury-immediate and delayed memory for 5 words and a visual analog scale score of acute headache-provided 80% sensitivity and 76% specificity for the prediction of clinically significant symptoms at 3 months postinjury.

 

Conclusion: A small combination of variables assessable in the ED may predict MTBI patients likely to experience persistent postconcussive symptoms.