Archives of physical medicine and rehabilitation · 2026
Long-Term Outcomes of Patients Seeking Specialized Health Care for Persisting Postconcussion Symptoms After a Mild Head Injury.
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Fordal Linda, Stenberg Jonas, Follestad Turid, Saksvik Simen B, Skirbekk Helge, Olsen Alexander, Skandsen Toril
Аннотация
OBJECTIVE: To examine long-term outcomes of persisting postconcussion symptoms (PPCS) after mild head injury in patients seeking specialist care.
DESIGN: Longitudinal cohort study. Baseline interview at outpatient admission and follow-up interviews at 3, 6, 12, 18, 24, 30, 36, 48, and 60 months postinjury, and 5 years after outpatient admission.
SETTING: Rehabilitation clinic.
PARTICIPANTS: Patients (N=191) with PPCS after mild head injury over the past 5 years.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Symptoms assessed by Rivermead Postconcussion Symptoms Questionnaire, functioning via Glasgow Outcome Scale-Extended and return to full-time work. Linear and logistic mixed models with and without interaction terms evaluated outcomes over time, while within-subject change was assessed from participants' first to last assessments.
RESULTS: The sample comprised 800 assessments (mean 4.2 [SD, 1.7] per participant). Patients were divided into groups by time from injury to outpatient admission (group 1: 0-3mo [n=44]; group 2: 3-6mo [n=54]; group 3: 6-12mo [n=47]; group 4: 12-24mo [n=26]; group 5: 24-60mo [n=20]). Although the groups had similar clinical characteristics at outpatient admission, their outcomes over time differed. Substantial symptom reduction and functional improvement were observed over time in groups 1-4, but not in group 5. Most symptom relief across groups occurred in the months after outpatient admission.
CONCLUSIONS: In patients seeking care for PPCS, most exhibited improvement over time and worsening was rare. However, many still experienced symptoms years after outpatient admission, and outpatient admission ≥2 years postinjury was associated with significantly poorer outcomes.
DESIGN: Longitudinal cohort study. Baseline interview at outpatient admission and follow-up interviews at 3, 6, 12, 18, 24, 30, 36, 48, and 60 months postinjury, and 5 years after outpatient admission.
SETTING: Rehabilitation clinic.
PARTICIPANTS: Patients (N=191) with PPCS after mild head injury over the past 5 years.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Symptoms assessed by Rivermead Postconcussion Symptoms Questionnaire, functioning via Glasgow Outcome Scale-Extended and return to full-time work. Linear and logistic mixed models with and without interaction terms evaluated outcomes over time, while within-subject change was assessed from participants' first to last assessments.
RESULTS: The sample comprised 800 assessments (mean 4.2 [SD, 1.7] per participant). Patients were divided into groups by time from injury to outpatient admission (group 1: 0-3mo [n=44]; group 2: 3-6mo [n=54]; group 3: 6-12mo [n=47]; group 4: 12-24mo [n=26]; group 5: 24-60mo [n=20]). Although the groups had similar clinical characteristics at outpatient admission, their outcomes over time differed. Substantial symptom reduction and functional improvement were observed over time in groups 1-4, but not in group 5. Most symptom relief across groups occurred in the months after outpatient admission.
CONCLUSIONS: In patients seeking care for PPCS, most exhibited improvement over time and worsening was rare. However, many still experienced symptoms years after outpatient admission, and outpatient admission ≥2 years postinjury was associated with significantly poorer outcomes.