Department of Public Health, Erasmus University Medical Center Rotterdam, the Netherlands.
Institute of Medical Psychology and Medical Sociology, Georg-August-University, Göttingen, Germany.
Injury. 2019 May;50(5):1068-1074. doi: 10.1016/j.injury.2018.12.002. Epub 2018 Dec 7.
A subset of mild traumatic brain injury (mTBI) patients experience post-concussion symptoms. When a cluster of post-concussion symptoms persists for over three months, it is referred to as post-concussion syndrome (PCS). Little is known about the association between PCS and Health-Related Quality of Life (HRQoL) after mTBI. The aims of this study were to assess the implications of PCS on HRQoL six months after mTBI and the relationship between PCS and HRQoL domains. A prospective observational cohort study was conducted among a sample of mTBI patients. Follow-up postal questionnaires at six months after emergency department (ED) admission included socio-demographic information, the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), and HRQoL measured with the 36-item Short-Form Health Survey (SF-36) and the Perceived Quality of Life Scale (PQoL). In total, 731 mTBI patients were included, of whom 38.7% were classified as suffering from PCS. Patients with PCS had significantly lower scores on all SF-36 domains, lower physical and mental component summary scores and lower mean PQoL scores compared to patients without PCS. All items of the RPQ were negatively correlated to all SF-36 domains and PQoL subscale scores, indicating that reporting problems on any of the RPQ symptoms was associated with a decrease on different aspects of an individuals' HRQoL. To conclude, PCS is common following mTBI and patients with PCS have a considerably lower HRQoL. A better understanding of the relationship between PCS and HRQoL and possible mediating factors in this relationship could improve intervention strategies, the recovery process for mTBI patients and benchmarking.
轻度创伤性脑损伤 (mTBI) 患者中有一部分会出现脑震荡后症状。当一组脑震荡后症状持续超过三个月时，就被称为脑震荡后综合征 (PCS)。目前对于 mTBI 后 PCS 与健康相关生活质量 (HRQoL) 之间的关系知之甚少。本研究旨在评估 mTBI 后六个月 PCS 对 HRQoL 的影响，以及 PCS 与 HRQoL 各领域之间的关系。本研究为前瞻性观察队列研究，纳入了 mTBI 患者样本。在急诊科 (ED) 入院后六个月进行的随访邮政问卷调查包括社会人口统计学信息、Rivermead 脑震荡后症状问卷 (RPQ)，以及使用 36 项简短健康调查 (SF-36) 和感知生活质量量表 (PQoL) 测量的 HRQoL。共纳入 731 名 mTBI 患者，其中 38.7%被归类为患有 PCS。与无 PCS 的患者相比，PCS 患者在所有 SF-36 领域的得分均显著较低，身体和心理成分综合得分以及平均 PQoL 得分均较低。RPQ 的所有条目均与所有 SF-36 领域和 PQoL 子量表得分呈负相关，这表明报告 RPQ 症状中的任何问题都与个体 HRQoL 的不同方面的下降有关。总之，mTBI 后 PCS 很常见，且患有 PCS 的患者 HRQoL 明显较低。更好地理解 PCS 与 HRQoL 之间的关系以及这种关系中的可能中介因素，可以改善干预策略、mTBI 患者的康复过程和基准。
