Citation

Shahrestani S, Ballatori AM, Ton A, Chen XT, Zargarian A, Chan AK, Strickland B, Brunswick A, Micko A, Zada G. J. Neurotrauma 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2020.7467

PMID

unavailable

Abstract

Current guidelines for patients experiencing a concussion or mild traumatic brain injury (mTBI) often focus on conservative care and observation. However, mTBI may increase the risk of severe novel psychiatric disorders (NPDs) within 180 days, and long-term management of mTBI should include psychiatric evaluation in patient populations. Retrospective cohort analysis was conducted using 8-years of the Nationwide Readmission Database. All individuals who were admitted for concussion and were readmitted within 180 days were queried. This cohort was then subdivided based on age, sex, and whether they experienced loss of consciousness (LOC) to control for demographic-dependent confounding. A binary decision tree provided recommendations for patients who may be at risk of developing severe NPDs. Analysis included 12,080 patients who experienced concussion. Males and females with LOC had higher rates of depression in all age quartiles within 180 days (p<0.05). Young females with LOC had increased rates of suicidal ideation (p<0.01), and those older than 25 had increased rates of anxiety (p<0.005). Adult males with LOC had increased rates of suicidal ideation (p<0.002) and males >75 had increased rates of anxiety at readmission (p<0.05). Males without LOC had increased rates of depression (p<0.005), with men in the second quartile also at higher risk of developing anxiety (p<0.05). Females without LOC showed the fewest number of NPDs at readmission. Concussion may be associated with increased rates of NPDs within the first 6 months following discharge. We use this data to develop recommendations for psychiatric screening of patients with mTBI.

Language: en

Keywords

HEAD TRAUMA; TRAUMATIC BRAIN INJURY; NEUROPSYCHOLOGY