title: Long-term follow-up of patients with mild traumatic brain injury: a mixed-method study.
abstract: OBJECTIVE
  To characterize the long-term consequences of mild traumatic brain injury regarding post-concussion symptoms, post-traumatic stress, and quality of life; and to investigate differences between men and women.
  
  
  METHODS
  Retrospective mixed-methods study.
  
  
  METHODS
  Of 214 patients with mild traumatic brain injury seeking acute care, 163 answered questionnaires concerning post-concussion symptoms (Rivermead Post-Concussion Symptoms Questionnaire; RPQ), post-traumatic stress (Impact of Event Scale; IES), and quality of life (Short Form Health Survey; SF-36) 3 years post-injury. A total of 21 patients underwent a medical examination in connection with the survey. The patients were contacted 11 years later, and 10 were interviewed. Interview data were analysed with content analysis.
  
  
  RESULTS
  The mean total RPQ score was 12.7 (standard deviation; SD 12.9); 10.5 (SD 11.9) for men and 15.9 (SD 13.8) for women (p = 0.006). The 5 most common symptoms were fatigue (53.4%), poor memory (52.5%), headache (50.9%), frustration (47.9%) and depression (47.2%). The mean total IES score was 9.6 (SD 12.9) 7.1 (SD 10.3) for men and 13.0 (SD 15.2) for women (p = 0.004). In general, the studied population had low scores on the Short Form Health Survey (SF-36). The interviews revealed that some patients still had disabling post-concussion symptoms and consequences in many areas of life 11 years after the injury event.
  
  
  CONCLUSIONS
  Long-term consequences were present for approximately 50% of the patients 3 years after mild traumatic brain injury and were also reported 11 years after mild traumatic brain injury. This needs to be taken into account by healthcare professionals and society in general when dealing with people who have undergone mild traumatic brain injury.
authors.affiliation: Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden.
authors.forename: Sara
authors.initials: S
authors.lastname: Ahman
authors.forename: Britt-Inger
authors.initials: BI
authors.lastname: Saveman
authors.forename: Johan
authors.initials: J
authors.lastname: Styrke
authors.forename: Ulf
authors.initials: U
authors.lastname: Björnstig
authors.forename: Britt-Marie
authors.initials: BM
authors.lastname: Stålnacke
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D038223:Post-Concussion Syndrome / Q000453:epidemiology* / Q000209:etiology; D011788:Quality of Life; D012189:Retrospective Studies; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology