Sustained outcomes following mild traumatic brain injury: Results of a five-emergency department longitudinal study

Abstract

Objective: To report on the occurrence of sustained outcomes including post-concussion symptoms, health services used and indicators of social disruption following a mild traumatic brain injury (MTBI).

Research design: A dual cohort comparing MTBI Emergency Department (ED) patients and a comparison group of non-head injured ED patients.

Methods and procedures: The outcomes measures employed were the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) and indicators of health services used and social disruption all recorded at the ED and at 3 and 6 months post-ED discharge. ‘Sustained’ meant a positive response to these measures at 3 and 6 months.

Main outcomes and results: Reasonable follow-up success was achieved at 3 and 6 months and the cohorts were alike on all demographic descriptors. RPQ average score and symptom occurrence were far more frequent among MTBI patients than for the comparison cohort from 3 to 6 months. The use of health services and indicators of social disruption were also more frequent among MTBI post-discharge patients.

Conclusions: These findings argue that some with an MTBI suffer real complaints and they are sustained from 3 to at least 6 months. More effort should be given toward specificity of these symptoms from those reported by members of the comparison group.

• Cohort study
• comparison cohort
• emergency department
• inverse probability weighting
• outcomes
• persistent symptoms
• post-concussion
• Rivermead Post-Concussion Symptoms Questionnaire

Acknowledgements

The authors thank the directors of the five Emergency Departments at UCLA, UCI, UCSD Medical Centers and Sharp Memorial and Sharp Chula Vista hospitals who gave of their time and resources to facilitate the identification of research participants and the collection of relevant data. We also thank members of the University of California, Irvine Medical Research Associates Program and staff from Sharp Memorial Hospital Emergency and Trauma Departments for their invaluable assistance with emergency department facilitation and medical records access. The authors also thank the many college students from UCLA and the San Diego area who were extremely helpful with survey administration. This project would not have been successful without the tireless efforts toward participant follow-up by staff from the Southern California Injury Prevention Research Center.