Mild traumatic brain injury does not predict acute postconcussion syndrome

S. Meares, E. A. Shores, A. J. Taylor, J. Batchelor, R. A. Bryant, I. J. Baguley, J. Chapman, J. Gurka, K. Dawson, L. Capon, J. E. Marosszeky

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: The aetiology of postconcussion syndrome (PCS) following mild traumatic brain injury (mTBI) remains controversial. Identifying acute PCS (within the first 14 days after injury) may optimise initial recovery and rehabilitation, identify those at risk and increase understanding of PCS. Objective: To examine predictors of acute outcome by investigating the relationship between preinjury psychiatric disorder, demographic factors, injury related characteristics, neuropsychological and psychological variables and acute PCS. Methods: Prospective study of consecutive trauma admissions to a level 1 trauma hospital. The final sample comprised 90 patients with mTBI and 85 non-brain injured trauma controls. Individuals were administered a PCS checklist, and neuropsychological and psychological measures. Multiple imputation of missing data in multi-variable logistic regression and bivariate logistic regressions were used to predict acute PCS at a mean of 4.90 days after injury. Results: Diagnosis of acute PCS was not specific to mTBI (mTBI 43.3%; controls 43.5%). Pain was associated with acute PCS in mTBI. The strongest effect for acute PCS was a previous affective or anxiety disorder (OR 5.76, 95% CI 2.19 to 15.0). Females were 3.33 times more likely than males to have acute PCS (95% CI 1.20 to 9.21). The effect of acute post-traumatic stress and neuropsychological function on acute PCS was relatively small. Higher IQ was associated with acute PCS. Conclusions: There is a high rate of acute PCS in both mTBI and non-brain injured trauma patients. PCS was not found to be specific to mTBI. The use of the term PCS may be misleading as it incorrectly suggests that the basis of PCS is a brain injury.

LanguageEnglish
Pages300-306
Number of pages7
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume79
Issue number3
DOIs
Publication statusPublished - Mar 2008

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Brain Concussion
Wounds and Injuries
Logistic Models
Psychology

Bibliographical note

Copyright retained by the author(s). Article originally published in Journal of neurology, neurosurgery and psychiatry, Vol 79, Iss 3, pp 300-306. The original article can be found at http://dx.doi.org/10.1136/jnnp.2007.126565. Article archived for private and non-commercial use with the permission of the author and according to publisher conditions. For further information see http://www.bmj.com/.

Cite this

Meares, S. ; Shores, E. A. ; Taylor, A. J. ; Batchelor, J. ; Bryant, R. A. ; Baguley, I. J. ; Chapman, J. ; Gurka, J. ; Dawson, K. ; Capon, L. ; Marosszeky, J. E. / Mild traumatic brain injury does not predict acute postconcussion syndrome. In: Journal of Neurology, Neurosurgery and Psychiatry. 2008 ; Vol. 79, No. 3. pp. 300-306.
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title = "Mild traumatic brain injury does not predict acute postconcussion syndrome",
abstract = "Background: The aetiology of postconcussion syndrome (PCS) following mild traumatic brain injury (mTBI) remains controversial. Identifying acute PCS (within the first 14 days after injury) may optimise initial recovery and rehabilitation, identify those at risk and increase understanding of PCS. Objective: To examine predictors of acute outcome by investigating the relationship between preinjury psychiatric disorder, demographic factors, injury related characteristics, neuropsychological and psychological variables and acute PCS. Methods: Prospective study of consecutive trauma admissions to a level 1 trauma hospital. The final sample comprised 90 patients with mTBI and 85 non-brain injured trauma controls. Individuals were administered a PCS checklist, and neuropsychological and psychological measures. Multiple imputation of missing data in multi-variable logistic regression and bivariate logistic regressions were used to predict acute PCS at a mean of 4.90 days after injury. Results: Diagnosis of acute PCS was not specific to mTBI (mTBI 43.3{\%}; controls 43.5{\%}). Pain was associated with acute PCS in mTBI. The strongest effect for acute PCS was a previous affective or anxiety disorder (OR 5.76, 95{\%} CI 2.19 to 15.0). Females were 3.33 times more likely than males to have acute PCS (95{\%} CI 1.20 to 9.21). The effect of acute post-traumatic stress and neuropsychological function on acute PCS was relatively small. Higher IQ was associated with acute PCS. Conclusions: There is a high rate of acute PCS in both mTBI and non-brain injured trauma patients. PCS was not found to be specific to mTBI. The use of the term PCS may be misleading as it incorrectly suggests that the basis of PCS is a brain injury.",
author = "S. Meares and Shores, {E. A.} and Taylor, {A. J.} and J. Batchelor and Bryant, {R. A.} and Baguley, {I. J.} and J. Chapman and J. Gurka and K. Dawson and L. Capon and Marosszeky, {J. E.}",
note = "Copyright retained by the author(s). Article originally published in Journal of neurology, neurosurgery and psychiatry, Vol 79, Iss 3, pp 300-306. The original article can be found at http://dx.doi.org/10.1136/jnnp.2007.126565. Article archived for private and non-commercial use with the permission of the author and according to publisher conditions. For further information see http://www.bmj.com/.",
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Meares, S, Shores, EA, Taylor, AJ, Batchelor, J, Bryant, RA, Baguley, IJ, Chapman, J, Gurka, J, Dawson, K, Capon, L & Marosszeky, JE 2008, 'Mild traumatic brain injury does not predict acute postconcussion syndrome', Journal of Neurology, Neurosurgery and Psychiatry, vol. 79, no. 3, pp. 300-306. https://doi.org/10.1136/jnnp.2007.126565

Mild traumatic brain injury does not predict acute postconcussion syndrome. / Meares, S.; Shores, E. A.; Taylor, A. J.; Batchelor, J.; Bryant, R. A.; Baguley, I. J.; Chapman, J.; Gurka, J.; Dawson, K.; Capon, L.; Marosszeky, J. E.

In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 79, No. 3, 03.2008, p. 300-306.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Mild traumatic brain injury does not predict acute postconcussion syndrome

AU - Meares, S.

AU - Shores, E. A.

AU - Taylor, A. J.

AU - Batchelor, J.

AU - Bryant, R. A.

AU - Baguley, I. J.

AU - Chapman, J.

AU - Gurka, J.

AU - Dawson, K.

AU - Capon, L.

AU - Marosszeky, J. E.

N1 - Copyright retained by the author(s). Article originally published in Journal of neurology, neurosurgery and psychiatry, Vol 79, Iss 3, pp 300-306. The original article can be found at http://dx.doi.org/10.1136/jnnp.2007.126565. Article archived for private and non-commercial use with the permission of the author and according to publisher conditions. For further information see http://www.bmj.com/.

PY - 2008/3

Y1 - 2008/3

N2 - Background: The aetiology of postconcussion syndrome (PCS) following mild traumatic brain injury (mTBI) remains controversial. Identifying acute PCS (within the first 14 days after injury) may optimise initial recovery and rehabilitation, identify those at risk and increase understanding of PCS. Objective: To examine predictors of acute outcome by investigating the relationship between preinjury psychiatric disorder, demographic factors, injury related characteristics, neuropsychological and psychological variables and acute PCS. Methods: Prospective study of consecutive trauma admissions to a level 1 trauma hospital. The final sample comprised 90 patients with mTBI and 85 non-brain injured trauma controls. Individuals were administered a PCS checklist, and neuropsychological and psychological measures. Multiple imputation of missing data in multi-variable logistic regression and bivariate logistic regressions were used to predict acute PCS at a mean of 4.90 days after injury. Results: Diagnosis of acute PCS was not specific to mTBI (mTBI 43.3%; controls 43.5%). Pain was associated with acute PCS in mTBI. The strongest effect for acute PCS was a previous affective or anxiety disorder (OR 5.76, 95% CI 2.19 to 15.0). Females were 3.33 times more likely than males to have acute PCS (95% CI 1.20 to 9.21). The effect of acute post-traumatic stress and neuropsychological function on acute PCS was relatively small. Higher IQ was associated with acute PCS. Conclusions: There is a high rate of acute PCS in both mTBI and non-brain injured trauma patients. PCS was not found to be specific to mTBI. The use of the term PCS may be misleading as it incorrectly suggests that the basis of PCS is a brain injury.

AB - Background: The aetiology of postconcussion syndrome (PCS) following mild traumatic brain injury (mTBI) remains controversial. Identifying acute PCS (within the first 14 days after injury) may optimise initial recovery and rehabilitation, identify those at risk and increase understanding of PCS. Objective: To examine predictors of acute outcome by investigating the relationship between preinjury psychiatric disorder, demographic factors, injury related characteristics, neuropsychological and psychological variables and acute PCS. Methods: Prospective study of consecutive trauma admissions to a level 1 trauma hospital. The final sample comprised 90 patients with mTBI and 85 non-brain injured trauma controls. Individuals were administered a PCS checklist, and neuropsychological and psychological measures. Multiple imputation of missing data in multi-variable logistic regression and bivariate logistic regressions were used to predict acute PCS at a mean of 4.90 days after injury. Results: Diagnosis of acute PCS was not specific to mTBI (mTBI 43.3%; controls 43.5%). Pain was associated with acute PCS in mTBI. The strongest effect for acute PCS was a previous affective or anxiety disorder (OR 5.76, 95% CI 2.19 to 15.0). Females were 3.33 times more likely than males to have acute PCS (95% CI 1.20 to 9.21). The effect of acute post-traumatic stress and neuropsychological function on acute PCS was relatively small. Higher IQ was associated with acute PCS. Conclusions: There is a high rate of acute PCS in both mTBI and non-brain injured trauma patients. PCS was not found to be specific to mTBI. The use of the term PCS may be misleading as it incorrectly suggests that the basis of PCS is a brain injury.

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U2 - 10.1136/jnnp.2007.126565

DO - 10.1136/jnnp.2007.126565

M3 - Article

VL - 79

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EP - 306

JO - Journal of Neurology, Neurosurgery and Psychiatry

T2 - Journal of Neurology, Neurosurgery and Psychiatry

JF - Journal of Neurology, Neurosurgery and Psychiatry

SN - 0022-3050

IS - 3

ER -