The association of post-concussion and post-traumatic stress disorder symptoms with health-related quality of life, health care use and return-to-work after mild traumatic brain injury

van der Vlegel, Marjolein; Polinder, Suzanne; Mikolić, Ana; Kaplan, Rana; von Steinbuechel, Nicole; Plass, Anne Marie; Zeldovich, Marina; Van Praag, Dominique; Bockhop, Fabian; Cunitz, Katrin; Mueller, Isabelle; Haagsma, Juanita A.; Investigators, The Center-Tbi Participants And

doi:10.3390/jcm10112473

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The association of post-concussion and post-traumatic stress disorder symptoms with health-related quality of life, health care use and return-to-work after mild traumatic brain injury
Citation	van der Vlegel M, Polinder S, Mikolić A, Kaplan R, von Steinbuechel N, Plass AM, Zeldovich M, Van Praag D, Bockhop F, Cunitz K, Mueller I, Haagsma JA, Investigators TCTPA. J. Clin. Med. 2021; 10(11): e10112473.
Copyright	(Copyright © 2021, MDPI: Multidisciplinary Digital Publishing Institute)
DOI	10.3390/jcm10112473
PMID	unavailable
Abstract	Patients with mild traumatic brain injury (mTBI) are at risk for post-concussion (PC) symptoms and post-traumatic stress disorder (PTSD). The co-occurrence of PC and PTSD symptoms after mTBI in relation to health-related quality of life (HRQoL), health care utilization, and return to work has not yet been investigated. PC and PTSD symptoms were measured six months post-TBI by respectively the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) and the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5). Of the 1566 individuals after mTBI who met the inclusion criteria, 26.1% experienced PC symptoms (RPQ ≥16). Additionally, 9.8% experienced PTSD symptoms (PCL-5 ≥ 33), of which the vast majority (81%) also reported experiencing PC symptoms. Differences between patients with no/mild symptoms, with only PC, only PTSD, and both PC and PTSD symptoms in HRQoL, return to work, and rehabilitation were analyzed using logistic and linear regression analyses. Patients with PC and/or PTSD symptoms reported lower HRQoL, higher rates of rehabilitation, and lower return to work rates compared to patients with no/mild symptoms. Patients with both PC and PTSD symptoms reported significantly lower HRQoL (B = -2.73, CI = -4.65; -0.83, p < 0.001) compared to those with only PC symptoms, while there were no significant differences in their ongoing rehabilitation care (OR = 1.39, CI = 0.77-2.49, p = 0.272) and return to work rates (OR = 0.49, CI = 0.15-1.63, p = 0.246) at six months. These results underline the importance of the diagnosis and appropriate treatment of patients with mTBI, experiencing PC and/or PTSD symptoms. Language: en
Keywords	post-traumatic stress disorder; health-related quality of life; traumatic brain injury (TBI); post-concussion symptoms; Rivermead Post-Concussion Symptoms Questionnaire (RPQ); TBI outcome