Citation

Scheenen ME, Spikman JM, de Koning ME, van der Horn HJ, Roks G, Hageman G, van der Naalt J. J. Neurotrauma 2016; 34(1): 31-37.

Copyright

(Copyright © 2016, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2015.4381

PMID

unavailable

Abstract

Although most patients recover fully following mTBI, a minority (15-25%) of all patients develop persistent post-traumatic complaints (PTC) that interfere with the resumption of previous activities. An early identification of patients that are at-risk for PTC is currently performed by measuring the number of complaints in the acute phase. However, only part of this group will actually develop persisting complaints, stressing the need for studies on additional risk factors. This study aimed to compare this group of patients with many complaints to patients with few and no complaints to identify potential additional discriminating characteristics and to evaluate which of these factors have the most predictive value for being at-risk. We evaluated coping style, presence of psychiatric history, injury characteristics, mood-related symptoms and post-traumatic stress. We included 820 patients (Glasgow Coma Scale [GCS] score 13-15) admitted to three level 1 trauma centers as part of the UPFRONT-study. At two weeks after injury, 60% reported three or more complaints (PTC-high), 25% reported few complaints (PTC-low) and 15% reported no complaints (PTC-zero).

RESULTS showed that PTC-high consisted of more females (78% vs. 73% and 52%, p<.001), were more likely to have a psychiatric history (7% vs. 2% and 5%) and had a higher number of reported depression (22% vs. 6% and 3%, p<.001), anxiety (25% vs. 7% and 5%)and post-traumatic stress (37% vs. 27% and 19%, P<.001) than the PCC-low and PCC-zero groups. We conclude that in addition to reported complaints, psychological factors such as coping style, depression, anxiety and post-traumatic stress symptoms had the highest predictive value and should be taken into account in the identification of at risk patients for future treatment studies.

Language: en