The Journal of head trauma rehabilitation · 2025
Post-Concussion Symptoms in Older Adults Following a Mild Traumatic Brain Injury.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Massé-Pelletier Mathieu, Boucher Valérie, Le Sage Natalie, Neveu Xavier, Moore Lynne, Émond Marcel, Mercier Eric
Аннотация
OBJECTIVE: Main objective: to estimate the prevalence of post-concussion symptoms (PPCS) in patients aged ≥55 years. Secondary objective: to identify the predictive factors associated with PPCS in this age group.
SETTING: Seven Canadian academic Level I and Level II trauma centers' emergency department (ED).
PARTICIPANTS: 356 patients aged ≥55 years consulting in the ED within 24 hours of a mild traumatic brain injury (TBI) between July 2013 and October 2016 were included in this study.
DESIGN: This is a planned sub-analysis of a prospective multicenter cohort study. Patients were identified in the ED by emergency physicians and research assistants. Participants were contacted via telephone for follow-up at 7, 30, and 90 days post-mild TBI. During these follow-ups, research assistants assessed PPCS using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). A modified Poisson regression assessed the association between PPCS and potential predictors.
MAIN MEASURES: The main outcome of this study was the presence of PPCS at 90 days, defined as the presence of spontaneously described severe (RPQ ≥1 symptom of 4 points, or 2 symptoms of 3 points), persistent symptoms that affect the patients' life.
RESULTS: PPCS at 90 days was observed in 16%, [95% CI 12.6-20.2] of our cohort, and most of those reporting PPCS were aged between 55 and 65 years (63.2%). We identified 4 variables associated with PPCS: cervical sprains (RR: 2.28, [95% CI 1.34-3.86], P < .01), female sex (RR: 3.12 [95% CI 1.90-5.12], P < .01), at least 3 different prescribed medications (RR: 1.68 [95% CI 1.02-2.76], P < .05) and age, which appeared to be protective (RR: 0.63 [95% CI 0.42-0.92], P < .01).
CONCLUSION: Our results identified patient characteristics associated with PPCS that can be easily recognized in the ED, such as patient sex, the use of at least 3 different medications and the presence of cervical sprain. Early identification of older adults at higher risk of PPCS is important to optimize care and guide post-ED management.
SETTING: Seven Canadian academic Level I and Level II trauma centers' emergency department (ED).
PARTICIPANTS: 356 patients aged ≥55 years consulting in the ED within 24 hours of a mild traumatic brain injury (TBI) between July 2013 and October 2016 were included in this study.
DESIGN: This is a planned sub-analysis of a prospective multicenter cohort study. Patients were identified in the ED by emergency physicians and research assistants. Participants were contacted via telephone for follow-up at 7, 30, and 90 days post-mild TBI. During these follow-ups, research assistants assessed PPCS using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). A modified Poisson regression assessed the association between PPCS and potential predictors.
MAIN MEASURES: The main outcome of this study was the presence of PPCS at 90 days, defined as the presence of spontaneously described severe (RPQ ≥1 symptom of 4 points, or 2 symptoms of 3 points), persistent symptoms that affect the patients' life.
RESULTS: PPCS at 90 days was observed in 16%, [95% CI 12.6-20.2] of our cohort, and most of those reporting PPCS were aged between 55 and 65 years (63.2%). We identified 4 variables associated with PPCS: cervical sprains (RR: 2.28, [95% CI 1.34-3.86], P < .01), female sex (RR: 3.12 [95% CI 1.90-5.12], P < .01), at least 3 different prescribed medications (RR: 1.68 [95% CI 1.02-2.76], P < .05) and age, which appeared to be protective (RR: 0.63 [95% CI 0.42-0.92], P < .01).
CONCLUSION: Our results identified patient characteristics associated with PPCS that can be easily recognized in the ED, such as patient sex, the use of at least 3 different medications and the presence of cervical sprain. Early identification of older adults at higher risk of PPCS is important to optimize care and guide post-ED management.