Purpose

To elucidate the predictive factors for persistent post-concussion symptoms at 1 and 3 months following minor traumatic brain injuries (mTBIs) in patients with no psychiatric history.

Methods

This was an observational study in an academic trauma centre including adult patients with a history of mTBI and no psychiatric history. Exclusion criteria were missing the follow-up phone calls, radiologic abnormalities, simultaneous injuries and refusal to participate. Outcomes were post-concussion syndrome according to the international classification of diseases (ICD)-10 (ICD-PCS) and persistence of more than one mTBI related symptoms at 1 and 3 months post-injury.

Results

From 364 enrolled patients, 16 (4.4%) developed ICD-PCS, whereas 28 (7.6%) and 8(2.1%) reported more than one symptom at one and three months, respectively. Multivariable analysis showed associations between ICD-PCS with more than one initial symptom in the emergency department (ED) and the non-motor vehicle collision (non-MVC) impact mechanism with area under curve of 0.77. The former variable was associated with the persistence of more than one post-concussion symptom at one and three months.

Conclusion

More than one symptom in the ED and the mechanism of injury not related to MVCs (sports, violence or fall injuries) may predict symptom persistence. Early treatment and follow-up strategies may be beneficial for vulnerable patients.

中文翻译：

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轻度脑外伤且急诊科无精神病史的脑震荡后症状持续存在。

目的

为了阐明无精神病史的患者在轻度脑外伤（mTBI）后1个月和3个月后持续出现脑震荡后症状的预测因素。

方法

这是在学术创伤中心进行的一项观察性研究，其中包括具有mTBI病史且无精神病史的成年患者。排除标准包括随访电话遗漏，影像学异常，同时受伤和拒绝参加。根据国际疾病分类（ICD）-10（ICD-PCS），结果为脑震荡后综合征，受伤后1和3个月持续存在一种以上与mTBI相关的症状。

结果

在364名入组患者中，有16名（4.4％）患上了ICD-PCS，而分别有28名（7.6％）和8名（2.1％）在一个月和三个月内报告了一种以上的症状。多变量分析显示，急诊科（ED）出现多于一种初始症状的ICD-PCS与曲线下面积为0.77的非机动车碰撞（non-MVC）冲击机制之间存在关联。前一个变量与脑震荡后一个或三个月以上症状的持续存在有关。

结论

急诊部的一种以上症状以及与MVC无关的伤害机制（运动，暴力或跌倒伤害）可能预示着症状持续存在。早期治疗和随访策略可能对弱势患者有益。