Health Services Research, ScHARR, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.
Emerg Med J. 2012 Jun;29(6):451-4. doi: 10.1136/emj.2010.094755. Epub 2011 May 26.
To estimate the prevalence of post-concussive symptoms (PCS) following head injury among adolescents in full-time education and to identify prognostic factors at presentation to the emergency department (ED) that may predict the development of PCS.
An observational cohort study of all head injured patients aged 13-21 and in full-time education presenting to an inner city ED was performed. Subjects were followed up at 1 and 6 months after injury by structured telephone interview to assess for the presence of symptoms or ongoing disability. Presentation data of those identified as having PCS underwent regression analysis to isolate potential prognostic indicators for such problems.
Of the 188 patients recruited, 5.9% (95% CI 3.3% to 10.2%) still had some symptoms after 6 months, with half of these claiming that such symptoms were affecting everyday living. Of these patients, 82% were assaulted as the cause of their injury and nearly 40% had no conventional indicators of head injury severity at presentation. After 1 month, 46/188 (24.5%, 95% CI 18.9% to 31.1%) patients had some degree of symptoms, most of whom were discharged directly from the ED. Potential prognostic indicators identified were a reduced Glasgow Coma Score (GCS) (<15) at presentation and being assaulted as the cause of injury.
The prevalence of PCS 6 months following head injury for the selected sub-group was 5.9%, and 10.6% if assaulted. Most patients who developed PCS were discharged directly from the ED.
评估青少年在全日制教育中头部受伤后出现脑震荡后症状（PCS）的患病率，并确定在急诊科（ED）就诊时可能预测 PCS 发展的预后因素。
对所有 13-21 岁、全日制教育的头部受伤患者进行了一项观察性队列研究，并在受伤后 1 个月和 6 个月通过结构化电话访谈对其进行随访，以评估症状或持续残疾的存在情况。对被确定为患有 PCS 的患者的就诊数据进行回归分析，以确定此类问题的潜在预后指标。
在招募的 188 名患者中，5.9%（95%CI 3.3%至 10.2%）在 6 个月后仍有一些症状，其中一半患者表示这些症状影响日常生活。这些患者中，82%是因被殴打而受伤，近 40%在就诊时没有传统的头部受伤严重程度指标。在 1 个月时，188 名患者中有 46 名（24.5%，95%CI 18.9%至 31.1%）出现了某种程度的症状，其中大多数患者直接从 ED 出院。确定的潜在预后指标是就诊时格拉斯哥昏迷评分（GCS）降低（<15）和因被殴打而受伤。
在所选择的亚组中，头部受伤后 6 个月 PCS 的患病率为 5.9%，如果被殴打则为 10.6%。大多数出现 PCS 的患者直接从 ED 出院。
