Long-term outcomes of major trauma patients with concussion |
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| Institution: | 1. School of Public Health and Preventive Medicine, Monash University, Victoria, Australia;2. Emergency & Trauma Centre, The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria 3004, Australia;3. National Trauma Research Institute, The Alfred Hospital, Victoria, Australia;4. Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia;5. School of Psychological Sciences, Monash University, Victoria, Australia;6. Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Victoria, Australia;1. Emergency & Trauma Centre, The Alfred Hospital;2. National Trauma Research Institute, The Alfred Hospital;3. School of Public Health & Preventive Medicine, Monash University;4. Department of Clinical Haematology, Monash Health;5. Faculty of Medicine, University of Queensland;6. Joint Health Command, Australian Defence Force;7. Department of Intensive Care Medicine, Royal Brisbane and Women''s Hospital;1. School of Allied Health, La Trobe University, Bundoora, Melbourne, Australia;2. Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA;3. Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science Auckland University of Technology, Auckland, New Zealand;1. Department of Trauma and Acute Care Surgery, University of Colorado Health Medical Center of the Rockies, 2500 Rocky Mountain Avenue, Loveland, CO 80538, USA;2. Department of GI, Trauma, and Endocrine Surgery, University of Colorado Anschutz Medical Campus, 1635 Aurora Court, Aurora, CO 80045, USA;1. Center for Injury Research and Prevention, The Children''s Hospital of Philadelphia, United States of America;2. Perelman School of Medicine, University of Pennsylvania, United States of America;3. Sports Medicine Performance Center, The Children''s Hospital of Philadelphia, United States of America;4. Division of Emergency Medicine, The Children''s Hospital of Philadelphia, United States of America |
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| Abstract: | IntroductionConcussion may be sustained in the setting of injuries to multiple body regions and persistent effects of concussion may impact recovery. This project aimed to evaluate the association between concussion and 6-month and 12-month functional outcomes in survivors after major trauma.MethodsThis was a registry-based cohort study that included adult patients with major trauma who presented to hospital between 01 Jan 2008 and 31 Dec 2017 and survived to hospital discharge. We excluded patients presenting with a Glasgow Coma Scale score <13 and those diagnosed with other intracranial injuries. Additionally, from the non-concussed group, patients with fractured skull and/or face were excluded, with the assumption that such patients may have had undiagnosed concussion. A good recovery was considered for Glasgow Outcome Scale-Extended (GOS-E) scores of 7 or 8. In addition, we assessed for patient reported anxiety and/or depression measured using the 3-level EuroQol 5 dimensions questionnaire. A modified mixed effects Poisson models with random intercepts for participant was used to assess the association between concussion and outcome.ResultsThere were 28,161 eligible patients and 12,822 met inclusion criteria. Concussion was diagnosed in 1860 patients (14.5%; 95%CI: 13.9–15.1). There was no association between concussion and good recovery at 12 months (aRR 1.05 (95%CI: 0.99–1.11). There was no association between concussion and anxiety and/or depression at 12 months (aRR 1.03; 95%CI: 0.99–1.07).ConclusionsConcussion was sustained among 14.5% of included patients in the setting of major trauma but not associated with longer-term adverse outcomes using GOS-E. Concussed patients did not report differential rates of anxiety and/or depression. |
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