title: Prevalence and Predictors of Poor Recovery from Mild Traumatic Brain Injury.
abstract: Although most patients with mild traumatic brain injury (mTBI) recover within 3 months, a subgroup of patients experience persistent symptoms. Yet, the prevalence and predictors of persistent dysfunction in patients with mTBI remain poorly understood. In a longitudinal study, we evaluated predictors of symptomatic and cognitive dysfunction in adolescents and young adults with mTBI, compared with two control groups-patients with orthopedic injuries and healthy uninjured individuals. Outcomes were assessed at 3 months post-injury. Poor symptomatic outcome was defined as exhibiting a symptom score higher than 90% of the orthopedic control (OC) group, and poor cognitive outcome was defined as exhibiting cognitive performance poorer than 90% of the OC group. At 3 months post-injury, more than half of the patients with mTBI (52%) exhibited persistently elevated symptoms, and more than a third (36.4%) exhibited poor cognitive outcome. The rate of high symptom report in mTBI was markedly greater than that of typically developing (13%) and OC (17%) groups; the proportion of those with poor cognitive performance in the mTBI group exceeded that of typically developing controls (15.8%), but was similar to that of the OC group (34.9%). Older age at injury, female sex, and acute symptom report were predictors of poor symptomatic outcome at 3 months. Socioeconomic status was the only significant predictor of poor cognitive outcome at 3 months.
authors.affiliation: 1 Department of Neurosurgery, University of Pennsylvania School of Medicine , Philadelphia, Pennsylvania.
authors.forename: Amanda R
authors.initials: AR
authors.lastname: Rabinowitz
authors.affiliation: 2 Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine and the University of Texas-Houston Medical School.
authors.forename: Xiaoqi
authors.initials: X
authors.lastname: Li
authors.affiliation: 2 Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine and the University of Texas-Houston Medical School.|3 Department of Neurology, Baylor College of Medicine , Houston, Texas.|4 Michael E. DeBakey Veterans Affairs Medical Center , Houston, Texas.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: McCauley
authors.affiliation: 2 Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine and the University of Texas-Houston Medical School.|3 Department of Neurology, Baylor College of Medicine , Houston, Texas.|4 Michael E. DeBakey Veterans Affairs Medical Center , Houston, Texas.
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Wilde
authors.affiliation: 2 Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine and the University of Texas-Houston Medical School.
authors.forename: Amanda
authors.initials: A
authors.lastname: Barnes
authors.affiliation: 2 Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine and the University of Texas-Houston Medical School.
authors.forename: Gerri
authors.initials: G
authors.lastname: Hanten
authors.affiliation: 5 Department of Emergency Medicine, University of Texas Health Science Center , Houston, Texas.
authors.forename: Donna
authors.initials: D
authors.lastname: Mendez
authors.affiliation: 5 Department of Emergency Medicine, University of Texas Health Science Center , Houston, Texas.
authors.forename: James J
authors.initials: JJ
authors.lastname: McCarthy
authors.affiliation: 2 Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine and the University of Texas-Houston Medical School.|3 Department of Neurology, Baylor College of Medicine , Houston, Texas.|4 Michael E. DeBakey Veterans Affairs Medical Center , Houston, Texas.
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Levin
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001930:Brain Injuries / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D020127:Recovery of Function; D012737:Sex Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: cognitive function; human studies; recovery; traumatic brain injury