Citation

Lubbers V, Van den Hoven D, van der Naalt J, Jellema K, Van den Brand C, Backus B. J. Neurotrauma 2024; ePub(ePub): ePub.

Copyright

(Copyright © 2024, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2023.0302

PMID

38390830

Abstract

Around 16% of patients with mild traumatic brain injury (mTBI) develop a post-concussion syndrome (PCS) with persistent physical, neurological and behavioural complaints. PCS has a great impact on a patient's quality of life, often decreases the ability to return to work, and henceforth has a great economic impact. Recent studies suggest that early treatment can greatly improve prognosis and prevent long-term effects in these patients. However, early recognition of patients at high risk of PCS remains difficult. The objective of this systematic review is to assess risk factors associated with the development of PCS, it primarily aims at the group of non-hospitalized patients who were seen with mTBI at the Emergency Department (ED). We searched PubMed/MEDLINE, Cochrane Library and EMBASE on 23-09-2022 for prospective studies which assessed the risk factors for the development of PCS. Exclusion criteria were: retrospective studies, >20% CT abnormalities, <18 years of age, follow-up < four weeks, severe trauma, and study population <100 patients. The search strategy identified 1628 articles, of which 17 studies met eligibility criteria. Risk factors found in this systematic review are pre-existing psychiatric history, headache at the ED, neurological symptoms at the ED, female sex, CT abnormalities, pre-existent sleeping problems, and neck pain at the ED. This systematic review identified seven risk factors for development of PCS in patients with mTBI. Future research should assess if implementation of these risk factors into a risk stratification tool will assist the emergency physician in the identification of patients at high risk of PCS.

Language: en

Keywords

ADULT BRAIN INJURY; HEAD TRAUMA; TRAUMATIC BRAIN INJURY