Heng@Heng, Chua Swee@Goh Swee
(2016)
Post concussion syndrome following mild traumatic brain injury in Emergency Department HUSM.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction: Post-concussion syndrome is a treatable yet debilitating
complication that is frequently seen in patients who sustained mild traumatic
brain injury. Proper defining, evaluating and managing these patients and its
associating factors can alter clinical course and severity of the illness. Various
clinical tools were developed to aid proper diagnosis and management of these
patients.
Purpose: To determine the incidence of post-concussion syndrome and its
association risk factors in patients presenting with a mild traumatic brain injury
to the Emergency and Trauma Department Hospital USM.
Materials and methods: In this prospective cohort study, we recruited patients
with mild traumatic brain injury, who fulfilled the inclusion and exclusion criteria,
admitted directly or referral from local clinics to the Emergency and Trauma
Department Hospital USM. Baseline interviews were conducted on those
eligible consented patients to gather information on demographic data, type of
injury and risk factors on the day of injury. Subsequent telephone interviews
were carried out within 2 weeks after the initial presentation and postconcussion
symptoms were documented using the Rivermead Post-Concussion
Symptoms Questionnaires as the measurement tool. Present of three or moresymptoms were considered as post-concussion syndrome. Statistical analyses
were performed by using a simple and multiple logistic regressions. Adjusted
OR and 95% CI were computed, and a p-value of less than 0.05 was set.
Results: A total of 113 patients with mild traumatic brain injury were included in
this study, but only 80 patients have completed the study due to various
reasons. 16.3% of the patients have three or more post-concussion symptoms
at 2 weeks post mild TBI. The most common presenting symptoms were
headache (30%), feeling of dizziness (28.7%), fatigue, tiring more easily (8.8%),
nausea and/or vomiting (7.5%), and sleep disturbance (7.5%). Among the risk
factors examined, previous history of concussion was statistically significant for
post-concussion syndrome. Patients with previous history of concussion are 4
times more likely to experience Post-Concussion Syndrome as compared to
those without a previous history of concussion.
Conclusions: Our study suggested that the incidences of post-concussion
syndrome among patients with mild TBI are high, with previous history of
concussion as the predictive risk factors for the patients with mild TBI to
develop post-concussion syndrome.
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