Factors associated with persistent post-concussion symptoms following mild traumatic brain injury in adults.

Abstract

BACKGROUND AND AIMS: There is continuing controversy regarding factors associated with persistent symptoms following mild traumatic brain injury (mTBI). Information provision regarding expected symptoms and suggested management strategies is arguably important but is not routine practice and there is limited evidence regarding its impact. This study investigated the nature of persistent symptoms, anxiety levels and quality of life and factors associated with persistent symptoms factors associated with persistent symptoms reporting an average of 7-moths following uncomplicated mTBI, including the impact of receiving information about mTBI in the Emergency Department (ED). METHOD: 343 individuals with mTBI completed the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), the Anxiety scale of the Hospital Anxiety and Depression Scale, and Quality of Life - Short Form (QoL - SF-12) scale at an average of 7 months post-injury (SD=38.5 days). Individuals had been treated for their mTBI at one of 24 hospitals nation-wide. RESULTS: Overall, 18.7% of participants reported three or more post-concussional symptoms (PCS). Fatigue was the most commonly reported post-injury symptom (17.2%), followed by forgetfulness (14.6%). Clinically significant anxiety was reported in 12.8% of the sample and was associated with symptom reporting, as were SF-12 mental and physical QoL. Significant predictors of PCS reporting at follow-up were the presence of pre-injury psychiatric issues, experiencing loss of consciousness (LOC), and having no recall of receiving information about mTBI in the ED. CONCLUSIONS: This study confirms that LOC, together with pre-injury psychiatric issues are associated with persistent PCS. Not receiving mTBI information in the ED may also negatively influence symptom reporting.