title: Mild traumatic brain injury does not predict acute postconcussion syndrome.
abstract: BACKGROUND
  The aetiology of postconcussion syndrome (PCS) following mild traumatic brain injury (mTBI) remains controversial. Identifying acute PCS (within the first 14 days after injury) may optimise initial recovery and rehabilitation, identify those at risk and increase understanding of PCS.
  
  
  OBJECTIVE
  To examine predictors of acute outcome by investigating the relationship between preinjury psychiatric disorder, demographic factors, injury related characteristics, neuropsychological and psychological variables and acute PCS.
  
  
  METHODS
  Prospective study of consecutive trauma admissions to a level 1 trauma hospital. The final sample comprised 90 patients with mTBI and 85 non-brain injured trauma controls. Individuals were administered a PCS checklist, and neuropsychological and psychological measures. Multiple imputation of missing data in multivariable logistic regression and bivariate logistic regressions were used to predict acute PCS at a mean of 4.90 days after injury.
  
  
  RESULTS
  Diagnosis of acute PCS was not specific to mTBI (mTBI 43.3%; controls 43.5%). Pain was associated with acute PCS in mTBI. The strongest effect for acute PCS was a previous affective or anxiety disorder (OR 5.76, 95% CI 2.19 to 15.0). Females were 3.33 times more likely than males to have acute PCS (95% CI 1.20 to 9.21). The effect of acute post-traumatic stress and neuropsychological function on acute PCS was relatively small. Higher IQ was associated with acute PCS.
  
  
  CONCLUSIONS
  There is a high rate of acute PCS in both mTBI and non-brain injured trauma patients. PCS was not found to be specific to mTBI. The use of the term PCS may be misleading as it incorrectly suggests that the basis of PCS is a brain injury.
authors: Department of Psychology, Macquarie University, Sydney, Australia.
authors: S
authors: S
authors: Meares
authors: E A
authors: EA
authors: Shores
authors: A J
authors: AJ
authors: Taylor
authors: J
authors: J
authors: Batchelor
authors: R A
authors: RA
authors: Bryant
authors: I J
authors: IJ
authors: Baguley
authors: J
authors: J
authors: Chapman
authors: J
authors: J
authors: Gurka
authors: K
authors: K
authors: Dawson
authors: L
authors: L
authors: Capon
authors: J E
authors: JE
authors: Marosszeky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D001930:Brain Injuries / Q000175:diagnosis / Q000453:epidemiology*; D016022:Case-Control Studies; D015984:Causality; D015897:Comorbidity; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D010146:Pain / Q000453:epidemiology; D038223:Post-Concussion Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology