Description of the predictors of persistent post-concussion symptoms and disability after mild traumatic brain injury: the SHEFBIT cohort.

Introduction

Several patients who suffer Mild Traumatic Brain Injury (mTBI) develop Persistent Post-Concussion Symptoms (PPCS) and long-term disability. Current prognostic models for mTBI have a large unexplained variance, which limits their use in a clinical setting. Aim: This study aimed to identify background demographics and mTBI details that are associated with PPCS and long-term disability.

Methods

Patients from the SHEFfield Brain Injury after Trauma (SHEFBIT) cohort with mTBI in the Emergency Department (ED) were analysed as part of the study. PPCS and long-term disability were measured using the Rivermead Post-Concussion Questionnaire and the Rivermead Post-Injury Follow-up Questionnaire respectively, during follow up brain injury clinics.

Results

A representative mTBI sample of 647 patients was recruited with a follow-up rate of 89%. Non-attenders were older (p < 0.001), a greater proportion were retired (p < 0.001) and had a greater burden of comorbidity (p = 0.009). Multivariate analysis identified that female gender, previous psychiatric history, GCS <15, aetiology of assault and alcohol intoxication, were associated with worse recovery.

Conclusion

These findings will support and add to current understanding of MBTI recovery in pursuit of developing a validated prognostic model. This will allow for more accurate prognostication and eventual improved treatment for sufferers of this complex disorder.