Epidemiology and predictors of post-concussive syndrome after minor head injury in an emergency population
Epidemiology and predictors of post-concussive syndrome after minor head injury in an emergency population
复制标题
DOI：
10.1080/026990599121692
复制
发表时间：
1999-03-01
期刊：
影响因子：
1.9
通讯作者：
Dombovy, M
中科院分区：
文献类型：
--
作者：
Bazarian, JJ;Wong, T;Dombovy, M
目的：为了确定是否临床变量或神经行为测试（NBT）分数在艾德24小时内轻微头部损伤（MHI）预测脑震荡后综合征（PCS）的发展：方法：前瞻性，观察性研究71 MHI患者和60骨科控制。MHI定义为意识丧失< 10分钟或健忘症，GCS 15，PE上无颅骨骨折或新的神经系统病灶，CT上无脑损伤（如果做过）。所有患者均在急诊室接受七部分NBT测试。在1、3和6个月时进行电话随访，以确定患者是否符合DSM IV对PCS的定义。分析：逐步、多变量、Logistic回归。结果：1个月时PCS的预测因素为女性（OR = 7.8; 95% CI = 41.6，1.98），同时存在逆行性和顺行性遗忘（OR = 0.055; CI = 0.002，0.47），数字跨度向前评分（OR = 0.748; CI = 0.52，1.03）和霍普金斯言语学习A评分（OR = 0.786; CI = 0.65，0.91）; 3个月时，同时存在逆行性和顺行性遗忘（OR = 0.13; CI = 0.0，0.93），数字广度向前评分（OR = 0.744; CI = 0.58，0.94）。在6个月时，模型无变量。霍普金斯言语学习A评分> 25分的男性在1个月时没有PCS，而数字跨度向前评分< 9分的女性在1个月时有PCS。结论：性别和两种NBT有助于预测MHI后的PCS。
Objective: To determine if clinical variables or neurobehavioural test (NBT) scores obtained in the ED within 24 hours of minor head injury (MHI) predict the development of postconcussive syndrome (PCS).Methods: Prospective, observational study of 71 MHI patients and 60 orthopaedic controls. MHI defined as loss of consciousness < 10 minutes or amnesia, GCS 15, no skull fracture or new neurologic focality on PE, and no brain injury on CT (if done). All patients received a seven part NBT battery in the ED. Telephone follow-up was done at 1, 3 and 6 months to determine if patients met the DSM IV definition of PCS.Analysis: Stepwise, multivariate, logistic regression.Results: Predictors of PCS at 1 month were female gender (OR = 7.8; 95% CI = 41.6, 1.98), presence of both retrograde and anterograde amnesia (OR = 0.055; CI = 0.002, 0.47), Digit Span Forward Scores (OR = 0.748; CI = 0.52, 1.03) and Hopkins Verbal Learning A scores (OR = 0.786; CI = 0.65, 0.91); at 3 months, presence of both retrograde and anterograde amnesia (OR = 0.13; CI = 0.0, 0.93), Digit Span Forward Scores (OR = 0.744; CI = 0.58, 0.94). No variables Gt the model at 6 months. 92% of males scoring > 25 on Hopkins Verbal Learning A did not have PCS at 1 month, and 89% of females scoring < 9 on Digit Span Forward did have PCS at 1 month.Conclusions: Gender and two NBTs can help predict PCS after MHI.