TY - JOUR PY - 2017// TI - Staying in service with posttraumatic headache: a retrospective cohort study of patient outcome JO - Neurology A1 - Finkel, Alan G. A1 - Klaric, John S. A1 - Yerry, Juanita A. A1 - Choi, Young S. SP - 1186 EP - 1194 VL - 89 IS - 11 N2 - OBJECTIVE: To predict the probability of a military outcome (medical discharge/retirement) in patients with mild traumatic brain injury from a clinical analysis of predetermined patient and headache characteristics.

METHODS: This retrospective cohort study sampled all new patients referred for headache evaluation at the Brain Injury Clinic of the Womack Army Medical Center, Ft. Bragg, NC (August 2008-January 2010). Headache characteristics were extracted and analyzed. Multivariable binary logistic regressions were conducted to predict probability of medical discharge/retirement.

RESULTS: Ninety-five soldiers (age 31.3 ± 7.4 years, male 93.7%) reported 166 headaches. The most common injury cited was a blast (53.7%). Patients with a continuous headache have almost 4 times the odds of a medically related discharge/retirement compared to patients without such a headache (continuous headache regression coefficient estimate: p < 0.042, odds ratio 3.98, 95% Wald confidence interval 1.05-15.07).

RESULTS suggest that, compared to service members who did not have a continuous headache, patients with headache histories with severe holocephalic pain who medicate to keep functioning had the highest probability of medical discharge/retirement.

CONCLUSIONS: Certain headache characteristics may be predictive of military outcomes after mild traumatic brain injury, and we propose a profile that may be useful in that prediction. These data could be useful in future attempts to assess and treat patients with posttraumatic headache and to advise longer-term planning for return to duty or discharge.

© 2017 American Academy of Neurology.

Language: en

LA - en SN - 0028-3878 UR - http://dx.doi.org/10.1212/WNL.0000000000004358 ID - ref1 ER -