title: Who gets post-concussion syndrome? An emergency department-based prospective analysis.
abstract: BACKGROUND
  The objective of this study was to determine who gets post-concussion syndrome (PCS) after mild traumatic brain injury or head injury.
  
  
  METHODS
  Patients presented within an hour of mild traumatic brain injury (mTBI). Written informed consent was obtained from all patients, who then provided detailed answers to surveys at the time of injury as well as at 1 week and 1 month follow-up. Statistical analyses were performed using JMP 11.0 for the Macintosh.
  
  
  RESULTS
  The most commonly reported symptoms of PCS at first follow-up were headache (27%), trouble falling asleep (18%), fatigue (17%), difficulty remembering (16%), and dizziness (16%). Furthermore, only 61% of the cohort was driving at 1 week follow-up, compared to 100% prior to the injury. Linear regression analysis revealed the consumption of alcohol prior to head injury, the mechanism of head injury being a result of motor vehicle collision (MVC) or fall, and the presence of a post-injury headache to be significantly associated with developing PCS at 1 week follow-up, while the occurrence of a seizure post-injury or having an alteration in consciousness post-injury was significantly associated with developing PCS at 1 month follow-up. On multivariate regression analysis, the presence of a headache post-injury was the most robust predictor, retaining statistical significance even after controlling for age, gender, and presence of loss of consciousness (LOC), alteration of consciousness (AOC), post-traumatic amnesia (PTA), seizure, or vomiting.
  
  
  CONCLUSIONS
  The results of this prospective study suggest that headache right after the head injury, an alteration of consciousness after the head injury, and alcohol consumption prior to the head injury are significant predictors of developing PCS, which occurs with equal frequency in men and women. Early identification of those who are at risk of developing PCS would diminish the burden of the injury and could potentially reduce the number of missed work and school days.
authors: North Florida South Georgia Veterans Affairs Medical Center, 1601 Archer Road, Gainesville 32610, FL, USA.
authors: Latha
authors: L
authors: Ganti
authors: The University of Florida College of Medicine, Gainesville 32610, FL, USA.
authors: Hussain
authors: H
authors: Khalid
authors: Department of Emergency Medicine, UF Health, Gainesville 32610, FL, USA.
authors: Pratik Shashikant
authors: PS
authors: Patel
authors: Department of Emergency Medicine, UF Health, Gainesville 32610, FL, USA.
authors: Yasamin
authors: Y
authors: Daneshvar
authors: Department of Emergency Medicine, UF Health, Gainesville 32610, FL, USA.
authors: Aakash N
authors: AN
authors: Bodhit
authors: Department of Radiology, UF Health, Gainesville 32610, FL, USA ; Department of Neurological Surgery, UF Health, Gainesville 32610, FL, USA.
authors: Keith R
authors: KR
authors: Peters
keywords: Emergency department; Mild traumatic brain injury; Post-concussion syndrome
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