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Persistent problems 1 year after mild traumatic brain injury: a longitudinal population study in New Zealand
Authors:Alice Theadom  Varsha Parag  Tony Dowell  Kathryn McPherson  Nicola Starkey  Suzanne Barker-Collo  Kelly Jones  Shanthi Ameratunga  Valery L Feigin  on behalf of the BIONIC Research Group
Abstract:

Background

Mild traumatic brain injury (mTBI) is a common problem in general practice settings, yet previous research does not take into account those who do not attend hospital after injury. This is important as there is evidence that effects may be far from mild.

Aim

To determine whether people sustain any persistent effects 1 year after mTBI, and to identify the predictors of health outcomes.

Design and setting

A community-based, longitudinal population study of an mTBI incidence cohort (n = 341) from a mixed urban and rural region (Hamilton and Waikato Districts) of the North Island of New Zealand (NZ).

Method

Adults (>16 years) completed assessments of cognitive functioning, global functioning, post-concussion symptoms, mood, and quality of life over the year after injury.

Results

Nearly half of participants (47.9%) reported experiencing four or more post-concussion symptoms 1 year post-injury. Additionally, 10.9% of participants revealed very low cognitive functioning. Levels of anxiety, depression, or reduced quality of life were comparable with the general population. Having at least one comorbidity, history of brain injury, living alone, non-white ethnic group, alcohol and medication use, and being female were significant predictors of poorer outcomes at 12 months.

Conclusion

Although some people make a spontaneous recovery after mTBI, nearly half continue to experience persistent symptoms linked to their injury. Monitoring of recovery from mTBI may be needed and interventions provided for those experiencing persistent difficulties. Demographic factors and medical history should be taken into account in treatment planning.
Keywords:epidemiology   head injury   mild traumatic brain injury   outcome   prediction
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