Article

OBJECTIVE: To examine
baseline variables and identify characteristics of participants with extremely
high reports of symptoms (ie, outliers) 12 months after mild head injury (MHI).
DESIGN: A prospective cohort study of MHI with and without loss of consciousness
(LOC) and/or posttraumatic amnesia (PTA) recruited from and interviewed at the
emergency department (ED), with a follow-up telephone interview at 12 months.
SETTING: Level II community hospital ED. PARTICIPANTS: Participants (n=58) with
MHI and LOC less than or equal to 30 minutes and/or PTA less than 24 hours and
participants (n=173) with MHI but no PTA/LOC. Inclusion criteria: age greater
than or equal to 18 years, less than or equal to 24 hours after injury, Glasgow
Coma Scale score greater than or equal to 13, and discharge from the ED. Fourteen
(6%) participants had extremely high scores on the Rivermead Postconcussion
Symptoms Questionnaire (RPQ). MAIN OUTCOME MEASURES: RPQ and questions on health
services use and litigation. RESULTS: Characterizing the outlier cases are prior
head injury, preinjury disability, history of substance use, unemployment, and
elevated somatic symptoms at the ED. At 12 months, outliers had higher use of
health services and litigation. CONCLUSIONS: The existence of a subgroup with a
distinctive pattern of baseline characteristics in combination with elevated
somatic symptoms at the time of presentation to the ED suggests that further
taxonomic distinctions may be warranted for the MHI population, each requiring
appropriately targeted interventions for addressing symptomatic complaints.
CI - Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS