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.
Rehabilitation Medicine, St Vincent's Hospital, Victoria Street, Darlinghurst, Sydney 2010, New South Wales, Australia. jmshe9@student.monash.edu
Joanne
J
Sheedy
Evelyn
E
Harvey
Steven
S
Faux
Gina
G
Geffen
E Arthur
EA
Shores
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