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创伤后头痛及其对轻度创伤性脑损伤后重返工作的影响。

Posttraumatic Headache and Its Impact on Return to Work After Mild Traumatic Brain Injury.

作者信息

Dumke Heike Andrea

机构信息

HeadWise Rehabilitation Inc, Surrey, and Faculty of Medicine, University of British Columbia, Vancouver, Canada.

出版信息

J Head Trauma Rehabil. 2017 Mar/Apr;32(2):E55-E65. doi: 10.1097/HTR.0000000000000244.

Abstract

OBJECTIVE

To examine the value of posttraumatic headaches in predicting return to work (RTW) in patients with mild traumatic brain injury (MTBI).

SETTING AND PARTICIPANTS

A total of 109 participants recruited from an outpatient head injury rehabilitation center, British Columbia, Canada.

DESIGN

Logistic regression analyses of secondary data.

MAIN MEASURE

The Numerical Pain Rating Scale (NPRS), measure of headache intensity. Nine resulting NPRS scores were used to predict successful versus unsuccessful RTW.

RESULTS

The largest effect size [odds ratio Exp(B)] value of 0.474] indicated that the odds of returning to work successfully are more than cut in half for each unit increase in NPRS rating.

CONCLUSION

To the author's knowledge, this is the first study of the impact of headache intensity on RTW for patients with MTBI. Posttraumatic headache severity after MTBI should be taken into account when developing models to predict RTW for this population. Headache intensity may act as a confounding variable for at least some injury characteristics (eg, cognitive functioning) and may add to the inconsistencies in the TBI and MTBI literature. Results may be utilized to guide rehabilitation efforts in planning RTW for patients with MTBI.

摘要

目的

探讨创伤后头痛对轻度创伤性脑损伤(MTBI)患者恢复工作(RTW)的预测价值。

设置与参与者

从加拿大不列颠哥伦比亚省的一家门诊脑损伤康复中心招募了109名参与者。

设计

对二手数据进行逻辑回归分析。

主要测量指标

数字疼痛评分量表(NPRS),用于测量头痛强度。九个由此得出的NPRS分数用于预测RTW成功与否。

结果

最大效应量[优势比Exp(B)]值为0.474]表明,NPRS评分每增加一个单位,成功恢复工作的几率就会减半以上。

结论

据作者所知,这是第一项关于头痛强度对MTBI患者RTW影响的研究。在为该人群开发预测RTW的模型时,应考虑MTBI后的创伤后头痛严重程度。头痛强度可能至少对某些损伤特征(如认知功能)起到混杂变量的作用,并可能加剧创伤性脑损伤(TBI)和MTBI文献中的不一致性。研究结果可用于指导为MTBI患者规划RTW的康复工作。

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