Fitness-to-drive after mild traumatic brain injury: Mapping the time trajectory of recovery in the acute stages post injury
Fitness-to-drive after mild traumatic brain injury: Mapping the time trajectory of recovery in the acute stages post injury
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DOI：
10.1016/j.aap.2015.03.014
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发表时间：
2015-06-01
影响因子：
5.9
通讯作者：
Lannin, Natasha A.
中科院分区：
文献类型：
--
作者：
Baker, Anne;Unsworth, Carolyn A.;Lannin, Natasha A.
引言：关于轻度创伤性脑损伤（mTBI）后驾驶适应性恢复的轨迹知之甚少。这意味着，医疗保健专业人员有有限的证据，根据建议，这一队列约driving.Objective：确定健身驱动状态的患者与mTBI在24小时和两个星期后injure. Method后，总结问题，由这一队列报告约返回到driving.Method：准实验病例对照设计。招募了两组参与者：mTBI患者（n = 60）和骨科损伤对照组（n = 60）。两组在受伤后24小时进行了驾驶适应性评估。主要测量指标：简易精神状态检查、职业治疗-回家迷宫测试（OT-DHMT）、道路法道路工艺测试、昆士兰大学-危险感知测试，以及在24 h和2周收集的人口统计学/访谈表。在24小时评估时，只有OT-DHMT显示两组之间的评分差异，mTBI参与者完成测试的速度明显较慢（p = 0.01）。在两周的随访中，60名mTBI参与者中只有26人恢复了驾驶。损伤严重程度结合24小时评估的分数预测了恢复驾驶所需时间的方差为31%。据报告，延迟恢复驾驶的原因是：“感觉不是100%正确”（n = 14，23%），头痛和疼痛结论：本研究支持现行指南中建议mTBI患者24小时内不应开车的建议;然而，还需要进一步研究，以确定有助于及时恢复驾驶的因素。(C)2015爱思唯尔有限公司版权所有。
Introduction: Little is known about the trajectory of recovery in fitness-to-drive after mild traumatic brain injury (mTBI). This means that health-care professionals have limited evidence on which to base recommendations to this cohort about driving.Objective: To determine fitness-to-drive status of patients with a mTBI at 24 h and two weeks post injury, and to summarise issues reported by this cohort about return to driving.Method: Quasi-experimental case-control design. Two groups of participants were recruited: patients with a mTBI (n = 60) and a control group with orthopaedic injuries (n = 60). Both groups were assessed at 24 h post injury on assessments of fitness-to-drive. Follow-up occurred at two weeks post injury to establish driver status.Main Measures: Mini mental state examination, occupational therapy-drive home maze test (OT-DHMT), Road Law Road Craft Test, University of Queensland-Hazard Perception Test, and demographic/interview form collected at 24 h and at two weeks.Results: At the 24 h assessment, only the OT-DHMT showed a difference in scores between the two groups, with mTBI participants being significantly slower to complete the test (p = 0.01). At the two week follow-up, only 26 of the 60 mTBI participants had returned to driving. Injury severity combined with scores from the 24 h assessment predicted 31% of the variance in time taken to return to driving. Delayed return to driving was reported due to: "not feeling 100% right" (n = 14, 23%), headaches and pain (n = 12, 20%), and dizziness (n=5, 8%).Conclusion: This research supports existing guidelines which suggest that patients with a mTBI should not to drive for 24h; however, further research is required to map factors which facilitate timely return to driving. (C) 2015 Elsevier Ltd. All rights reserved.