ABSTRACT

Objectives: To compare post-concussion symptoms (PCS) and return to normal activities between mild Traumatic Brain Injury (mTBI) patients with or without concomitant injuries at 7-and 90 days post-mTBI.Methods: Design: Sub-analysis of a multicentre prospective cohort study. Participants and setting: patients with mTBI from 7 Canadian Emergency Departments. Procedure: Research assistants conducted telephone follow-ups using the Rivermead Postconcussion Symptoms Questionnaire (RPQ) at 7-, 30- and 90 days post-mTBI. Main outcome: Presence of PCS (RPQ: ≥3 symptoms) at 90 days. Secondary outcomes: RPQ score ≥21, prevalence of individual RPQ symptoms and patients’ return to normal activities, at 7- and 90-days. Adjusted risk ratios (RR) were calculated.Results: 1725 mTBI patients were included and 1055 (61.1%) had concomitant injuries. Patients with concomitant injuries were at higher risk of having ≥3 symptoms on the RPQ (RR:1.26 [95% CI 1.01–1.58]) at 90 days. They were also at higher risk of experiencing specific symptoms (dizziness, fatigue, headaches and taking longer to think) and of non-return to their normal activities (RR:2.11 [95% CI 1.30–3.45]).Conclusion: Patients with concomitant injuries have slightly more PCS and seemed to be at higher risk of non-return to their normal activities 90 days, compared to patients without concomitant injuries.

摘要

目的：比较轻度创伤性脑损伤 (mTBI) 患者在 mTBI 后 7 天和 90 天有或没有伴随损伤的脑震荡后症状 (PCS) 和恢复正常活动。方法：设计：多中心前瞻性队列研究的子分析。参与者和环境：来自 7 个加拿大急诊室的 mTBI 患者。程序：研究助理在 mTBI 后 7、30 和 90 天使用 Rivermead 脑震荡后症状问卷 (RPQ) 进行电话随访。主要结果：90 天时出现 PCS（RPQ：≥3 种症状）。次要结果：RPQ 评分 ≥ 21、个体 RPQ 症状的流行以及患者在 7 天和 90 天恢复正常活动。计算调整后的风险比 (RR)。结果：包括 1725 名 mTBI 患者，1055 名 (61.1%) 有伴随损伤。伴随损伤的患者在 90 天时在 RPQ 中出现≥3 种症状的风险较高（RR：1.26 [95% CI 1.01–1.58]）。他们出现特定症状（头晕、疲劳、头痛和思考时间更长）和无法恢复正常活动的风险也更高（RR：2.11 [95% CI 1.30–3.45]）。结论：与没有伴随损伤的患者相比，伴随损伤的患者 PCS 稍多，并且在 90 天后无法恢复正常活动的风险似乎更高。