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Open AccessArticle

Post-Concussion Symptoms in Complicated vs. Uncomplicated Mild Traumatic Brain Injury Patients at Three and Six Months Post-Injury: Results from the CENTER-TBI Study

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Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
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Department of Neurosurgery, Antwerp University Hospital, 2650 Edegem, Belgium
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Department of Neurosurgery, University of Antwerp, 2000 Edegem, Belgium
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Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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Clinic of Neurosurgery, Clinical Centre of Vojvodina, 21000 Novi Sad, Serbia
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Institute of Medical Psychology and Medical Sociology, University Medical Göttingen (UMG), 37075 Göttingen, Germany
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Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0372 Oslo, Norway
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Faculty of Medicine, Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), University of Oslo, 0318 Oslo, Norway
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Author to whom correspondence should be addressed.
CENTER-TBI Participants and Investigators listed in the Supplementary Materials (File 1).
J. Clin. Med. 2019, 8(11), 1921; https://doi.org/10.3390/jcm8111921
Received: 4 October 2019 / Revised: 2 November 2019 / Accepted: 6 November 2019 / Published: 8 November 2019
(This article belongs to the Section Clinical Neurology)
The aim of this study was to assess the occurrence of post-concussion symptoms and post-concussion syndrome (PCS) in a large cohort of patients after complicated and uncomplicated mild traumatic brain injury (mTBI) at three and six months post-injury. Patients were included through the prospective cohort study: Collaborative European NeuroTrauma Effectiveness Research (CENTER-TBI). Patients enrolled with mTBI (Glasgow Coma Scale 13–15) were further differentiated into complicated and uncomplicated mTBI based on the presence or absence of computed tomography abnormalities, respectively. The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) assessed post-concussion symptoms and PCS according to the mapped ICD-10 classification method. The occurrence of post-concussion symptoms and syndrome at both time points was calculated. Chi square tests were used to test for differences between and within groups. Logistic regression was performed to analyse the association between complicated versus uncomplicated mTBI and the prevalence of PCS. Patients after complicated mTBI reported slightly more post-concussion symptoms compared to those after uncomplicated mTBI. A higher percentage of patients after complicated mTBI were classified as having PCS at three (complicated: 46% vs. uncomplicated: 35%) and six months (complicated: 43% vs. uncomplicated 34%). After adjusting for baseline covariates, the effect of complicated versus uncomplicated mTBI at three months appeared minimal: odds ratio 1.25 (95% confidence interval: 0.95–1.66). Although patients after complicated mTBI report slightly more post-concussion symptoms and show higher PCS rates compared to those after uncomplicated mTBI at three and six months, complicated mTBI was only found a weak indicator for these problems. View Full-Text
Keywords: complicated mild traumatic brain injury; post-concussion symptoms; post-concussion syndrome; traumatic brain injury complicated mild traumatic brain injury; post-concussion symptoms; post-concussion syndrome; traumatic brain injury
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Voormolen, D.C.; Haagsma, J.A.; Polinder, S.; Maas, A.I.; Steyerberg, E.W.; Vuleković, P.; Sewalt, C.A.; Gravesteijn, B.Y.; Covic, A.; Andelic, N.; Plass, A.M.; von Steinbuechel, N.; on behalf of the CENTER-TBI Participants and Investigators. Post-Concussion Symptoms in Complicated vs. Uncomplicated Mild Traumatic Brain Injury Patients at Three and Six Months Post-Injury: Results from the CENTER-TBI Study. J. Clin. Med. 2019, 8, 1921.

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