Emergency department assessment of mild traumatic brain injury and the prediction of postconcussive symptoms: a 3-month prospective study.
OBJECTIVE
To investigate the utility of a brief emergency department (ED) bedside screen for the prediction of postconcussive symptoms at 3 months following mild traumatic brain injury (MTBI).


METHODS
One hundred patients with MTBI (78% men; mean age = 33.6 years); 2 control groups (each n = 100), a "minor nonhead injury" group (77% men; mean age = 32.2 years) and an "uninjured ED visitor" group (78% men; mean age = 33.6 years).


METHODS
Brief measures of neuropsychological functioning, acute pain, and postural stability were collected in the ED; telephone follow-up at 3 months using the Rivermead Post-Concussion Symptoms Questionnaire was undertaken.


RESULTS
Neuropsychological deficits, acute pain, and postural instability in the ED were significantly associated with postconcussive symptoms at 3-month follow-up. A regression formula using 3 easily obtainable measures obtained during acute stage of injury-immediate and delayed memory for 5 words and a visual analog scale score of acute headache-provided 80% sensitivity and 76% specificity for the prediction of clinically significant symptoms at 3 months postinjury.


CONCLUSIONS
A small combination of variables assessable in the ED may predict MTBI patients likely to experience persistent postconcussive symptoms.
Sheedy
Joanne
J
Rehabilitation Medicine, St Vincent's Hospital, Victoria Street, Darlinghurst, Sydney 2010, New South Wales, Australia. jmshe9@student.monash.edu
Harvey
Evelyn
E
Faux
Steven
S
Geffen
Gina
G
Shores
E Arthur
EA
D000328:Adult; D001924:Brain Concussion / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening; D009460:Neurologic Examination / Q000706:statistics & numerical data; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D009517:New South Wales; D010147:Pain Measurement / Q000706:statistics & numerical data; D038223:Post-Concussion Syndrome / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation; D004856:Postural Balance; D011379:Prognosis; D011446:Prospective Studies; D011594:Psychometrics; D012050:Rehabilitation, Vocational; D018570:Risk Assessment; D055815:Young Adult