Outcome after mild to moderate traumatic brain injury: the role of dizziness.
OBJECTIVE
To assess the specific effect of dizziness on psychosocial outcome after mild to moderate traumatic brain injury (TBI).


METHODS
Six-month cross-sectional study. Setting An outpatient TBI clinic in a tertiary care referral center. Participants A consecutive sample of 207 adults with mild to moderate TBI, 138 (66.7%) of whom had subjective complaint of posttraumatic dizziness.


METHODS
Not applicable.


METHODS
Psychosocial indices (Glasgow Outcome Scale [GOS], General Health Questionnaire [GHQ], Rivermead Head Injury Follow-Up Questionnaire [RHFUQ], return to work status) were collected from dizzy and nondizzy patients.


RESULTS
Despite similar demographic, TBI, and global disability (GOS) profiles of both groups, psychosocial functioning (GHQ, RHFUQ, return to work) was significantly worse in dizzy subjects ( P <.01 for all indices). A logistic regression analysis identified dizziness ( P =.006), total GHQ ( P =.001), and psychotropic and analgesic use ( P =.05) as significant independent predictors of reemployment.


CONCLUSIONS
Although dizziness was closely linked to psychologic distress at 6 months after head injury, it also emerged as an independent predictor of failure to return to work, suggesting that not all its adverse effects on outcome are psychologically mediated. Clinicians need to be alert to the presence of dizziness as an adverse prognostic indicator after mild to moderate TBI.
University of Toronto, Toronto, ON, Canada.
Laury
L
Chamelian
Anthony
A
Feinstein
D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D001930:Brain Injuries / Q000150:complications*; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D017063:Outcome Assessment, Health Care; D038223:Post-Concussion Syndrome / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D020127:Recovery of Function / Q000502:physiology*
D000700:Analgesics; D011619:Psychotropic Drugs