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Brain injury : [BI] · Mar 1999
Epidemiology and predictors of post-concussive syndrome after minor head injury in an emergency population.
- J J Bazarian, T Wong, M Harris, N Leahey, S Mookerjee, and M Dombovy.
- Department of Emergency Medicine, University of Rochester Medical Center, NY 14642, USA. jeff_bazarian@urmc.rochester.edu
- Brain Inj. 1999 Mar 1; 13 (3): 173-89.
ObjectiveTo determine if clinical variables or neurobehavioural test (NBT) scores obtained in the ED within 24 hours of minor head injury (MHI) predict the development of postconcussive syndrome (PCS).MethodsProspective, observational study of 71 MHI patients and 60 orthopaedic controls. MHI defined as loss of consciousness < 10 minutes or amnesia, GCS 15, no skull fracture or new neurologic focality on PE, and no brain injury on CT (if done). All patients received a seven part NBT battery in the ED. Telephone follow-up was done at 1, 3 and 6 months to determine if patients met the DSM IV definition of PCS.AnalysisStepwise, multivariate, logistic regression.ResultsPredictors of PCS at 1 month were female gender (OR = 7.8; 95% CI = 41.6, 1.98), presence of both retrograde and anterograde amnesia (OR = 0.055; CI = 0.002, 0.47), Digit Span Forward Scores (OR = 0.748; CI = 0.52, 1.03) and Hopkins Verbal Learning A scores (OR = 0.786; CI = 0.65, 0.91); at 3 months, presence of both retrograde and anterograde amnesia (OR = 0.13; CI = 0.0, 0.93), Digit Span Forward Scores (OR = 0.744; CI = 0.58, 0.94). No variables fit the model at 6 months. 92% of males scoring > 25 on Hopkins Verbal Learning A did not have PCS at 1 month, and 89% of females scoring < 9 on Digit Span Forward did have PCS at 1 month.ConclusionsGender and two NBTs can help predict PCS after MHI.
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