Early intervention for patients at risk for persisting disability after mild traumatic brain injury: A randomized, controlled study

Abstract

Study objective: To investigate the effect of an early intervention visit in addition to written information and treatment as usual for patients with an estimated high risk for persisting disability after a mild traumatic brain injury (MTBI).

Research design: Randomized controlled trial.

Methods: One hundred and seventy-three patients, aged 15–70 years with a Glasgow Coma Scale of 14–15 were included. All received written information about MTBI. Ninety-seven patients who reported three or more symptoms according to the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) at 10 days after the injury were considered as high-risk patients and were randomized to either early visit to a doctor or to treatment as usual (TAU); all patients including the 76 low-risk patients were followed-up at 3 months. Completion rate was 83%. Outcome measures included RPQ and the Hospital Anxiety and Depression Scale.

Results: RPQ symptoms decreased significantly in both randomized groups, but were not significantly different in the groups at 3 months. At 3 months, anxiety and depression scores did not differ between groups.

Conclusions: An early intervention, offered to patients with an estimated high risk for persisting disability, had no additional effect on symptom level at 3 months after MTBI as compared to TAU.

• Mild brain injury
• intervention
• traumatic brain injury
• concussion

Acknowledgements

We would like to thank Dr Anders Lundin, MD PhD, for valuable contribution regarding intervention design, Gunnar Edman PhD, for statistical analysis, study co-ordinators Sandra Hallström and Seija Lund and all the study collaborators in Uppsala, Gothenburg, Jönköping and Stockholm. We also thank AFA insurance for funding.

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. This study was supported by grants from AFA insurance, No 060083. The funders had no input to the study design or analysis.