Research Reports - Prevalence and Predictors of poor recovery from mild traumatic brain injury

J Neurotrauma. 2015 Jul 17

Rabinowitz AR(1), Li X(2), McCauley SR(2,)(3,)(4), Wilde EA(2,)(3,)(4), Barnes
A(2), Hanten G(2), Mendez D(5), McCarthy JJ(5), Levin HS(2,)(3,)(4)

Although most patients with mild traumatic brain injury (mTBI) recover within 3
months, a subgroup of patients experience persistent symptoms. Yet, the
prevalence and predictors of persistent dysfunction in patients with mTBI remain
poorly understood. In a longitudinal study, we evaluated predictors of
symptomatic and cognitive dysfunction in adolescents and young adults with mTBI,
compared with two control groups-patients with orthopedic injuries and healthy
uninjured individuals. Outcomes were assessed at 3 months post-injury. Poor
symptomatic outcome was defined as exhibiting a symptom score higher than 90% of
the orthopedic control (OC) group, and poor cognitive outcome was defined as
exhibiting cognitive performance poorer than 90% of the OC group. At 3 months
post-injury, more than half of the patients with mTBI (52%) exhibited
persistently elevated symptoms, and more than a third (36.4%) exhibited poor
cognitive outcome. The rate of high symptom report in mTBI was markedly greater
than that of typically developing (13%) and OC (17%) groups; the proportion of
those with poor cognitive performance in the mTBI group exceeded that of
typically developing controls (15.8%), but was similar to that of the OC group
(34.9%). Older age at injury, female sex, and acute symptom report were
predictors of poor symptomatic outcome at 3 months. Socioeconomic status was the
only significant predictor of poor cognitive outcome at 3 months.

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