Early prediction of persisting post-concussion symptoms following mild and moderate head injuries.
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.
King
N S
NS
Oxford Regional Training Course in Clinical Psychology, Warneford Hospital, UK.
Crawford
S
S
Wenden
F J
FJ
Caldwell
F E
FE
Wade
D T
DT
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