title: Emergency department prediction of post-concussive  syndrome following mild traumatic brain injury--an  international cross-validation study.
abstract: BACKGROUND
  Between 20-50% of those suffering a mild traumatic brain injury (MTBI) will suffer symptoms beyond 3 months or post-concussive disorder (PCD). Researchers in Sydney conducted a prospective controlled study which identified that bedside recordings of memory impairment together with recordings of moderate or severe pain could predict those who would suffer PCS with 80% sensitivity and specificity of 76%.
  
  
  OBJECTIVE
  This study is a cross-validation study of the Sydney predictive model conducted at Montreal General Hospital, Montreal, Canada.
  
  
  METHODS
  One hundred and seven patients were assessed in the Emergency Department following a MTBI and followed up by phone at 3 months. The Rivermead Post-Concussive Questionnaire was the main outcome measure.
  
  
  RESULTS
  Regression analysis showed that immediate verbal recall and quantitative recording of headache was able to predict PCD with a sensitivity of 71.4% and a specificity of 63.3%. In the combined MTBI groups from Sydney and Montreal the sensitivity was 70.2% and the specificity was 64.2%.
  
  
  CONCLUSIONS
  This is the first study to compare populations from different countries with diverse language groups using a predictive model for identifying PCD following MTBI. The model may be able to identify an 'at risk' population to whom pre-emptive treatment can be offered.
authors.affiliation: St Vincent's Hospital, Sydney, NSW, Australia. sfaux@stvincents.com.au
authors.forename: Steven
authors.initials: S
authors.lastname: Faux
authors.forename: Jo
authors.initials: J
authors.lastname: Sheedy
authors.forename: R
authors.initials: R
authors.lastname: Delaney
authors.forename: Richard
authors.initials: R
authors.lastname: Riopelle
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D004636:Emergency Service, Hospital; D005260:Female; D005544:Forecasting; D016489:Head Injuries, Closed / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010147:Pain Measurement; D038223:Post-Concussion Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D011379:Prognosis; D011446:Prospective Studies; D011792:Quebec / Q000453:epidemiology; D011795:Surveys and Questionnaires