title: Early prediction of persisting post-concussion symptoms following mild and moderate head injuries.
abstract: King (1996) reported that a combination of emotional, organic and neuropsychological measures taken at 7-10 days following mild and moderate head injury may significantly help predict patients most likely to suffer persisting post-concussion symptoms (PCS) at three months post-injury. This study investigated a cross-validation sample (N = 57) to determine whether the results would be replicated for the early prediction of longer-term sufferers (i.e. those with persisting symptoms at 6 months post-injury).
  
  
  
  Multiple regression analyses were used in which scores on the Hospital Anxiety and Depression Scale, Impact of Event Scale, Short Orientation Memory and Concentration Test, Rivermead Post-Concussion Symptoms Questionnaire and Post-Traumatic Amnesia taken at 7-10 days post-injury were the independent measures. Scoring on the Rivermead Post-Concussion Symptoms Questionnaire taken at 6 months post-injury was the dependent measure.
  
  
  
  Sixty-six consecutive patients admitted to any trauma ward in Oxfordshire with a mild or moderate head injury were recruited from a largescale randomized controlled sample. The assessment measures were administered at 7-10 days post-injury and the Rivermead Post-Concussion Symptoms Questionnaire at 6 months post-injury. Nine patients were unable to be followed up, leaving an active sample of 57.
  
  
  
  The cross-validation data confirmed that a similar combination of measures to that found in the original study best predicted persisting PCS but that the strength of prediction diminished for the longer term prediction (i.e. 6 months post-injury).
  
  
  
  The Hospital Anxiety and Depression Scale, Impact of Even Scale and Post-Traumatic Amnesia in combination are recommended as useful prognostic screening instruments for predicting persisting PCS, but great caution is required if they are used to aid predictions beyond 3 months post-injury.
authors.affiliation: Oxford Regional Training Course in Clinical Psychology, Warneford Hospital, UK.
authors.forename: N S
authors.initials: NS
authors.lastname: King
authors.forename: S
authors.initials: S
authors.lastname: Crawford
authors.forename: F J
authors.initials: FJ
authors.lastname: Wenden
authors.forename: F E
authors.initials: FE
authors.lastname: Caldwell
authors.forename: D T
authors.initials: DT
authors.lastname: Wade
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001924:Brain Concussion / Q000175:diagnosis* / Q000209:etiology / Q000534:rehabilitation*; D001925:Brain Damage, Chronic / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D016489:Head Injuries, Closed / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards*; D011237:Predictive Value of Tests; D012044:Regression Analysis; D013997:Time Factors