Department of Emergency Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
BMC Neurol. 2020 Aug 26;20(1):315. doi: 10.1186/s12883-020-01887-x.
Acute neck pain (ANP) has recently been demonstrated to be a predictor of persistent posttraumatic complaints after mild traumatic brain injury (mTBI). The aim of this study was to determine specific characteristics of patients with ANP following mTBI, their posttraumatic complaints and relationship with functional outcome.
Data from a prospective follow-up study of 922 mTBI patients admitted to the emergency department (ED) in three level-one trauma centres were analysed. Patients were divided into two groups: 156 ANP patients and 766 no acute neck pain (nANP) patients. Posttraumatic complaints were evaluated 2 weeks and 6 months post-injury using standardized questionnaires and functional outcome was evaluated at 6 months with the Glasgow Outcome Scale Extended (GOSE).
ANP patients were more often female (p < 0.01), younger (38 vs. 47 years, p < 0.01) with more associated acute symptoms at the ED (p < 0.05) compared to nANP patients. More motor vehicle accidents (12% vs. 6%, p = 0.01) and less head wounds (58% vs. 73%, p < 0.01) in ANP patients indicated 'high-energy low-impact' trauma mechanisms. ANP patients showed more posttraumatic complaints 2 weeks and 6 months post-injury (p < 0.05) and more often incomplete recovery (GOSE < 8) was present after 6 months (56% vs. 40%, p = 0.01).
MTBI patients with acute neck pain at the ED constitute a distinct group within the mTBI spectrum with specific injury and demographic characteristics. Early identification of this at risk group already at the ED might allow specific and timely treatment to avoid development of incomplete recovery.
急性颈痛（ANP）最近被证明是轻度创伤性脑损伤（mTBI）后持续创伤后主诉的预测因素。本研究旨在确定 mTBI 后 ANP 患者的特定特征、他们的创伤后主诉以及与功能结局的关系。
分析了三个一级创伤中心急诊科收治的 922 例 mTBI 患者的前瞻性随访研究数据。患者分为两组：156 例 ANP 患者和 766 例无急性颈痛（nANP）患者。创伤后主诉在受伤后 2 周和 6 个月使用标准化问卷进行评估，功能结局在 6 个月时使用格拉斯哥结局量表扩展版（GOSE）进行评估。
与 nANP 患者相比，ANP 患者更多为女性（p<0.01）、年龄更小（38 岁 vs. 47 岁，p<0.01），急诊科急性症状更多（p<0.05）。ANP 患者中更多的是机动车事故（12% vs. 6%，p=0.01），而较少的头部伤口（58% vs. 73%，p<0.01），表明“高能量低冲击力”创伤机制。ANP 患者在受伤后 2 周和 6 个月时表现出更多的创伤后主诉（p<0.05），6 个月后更常出现不完全恢复（GOSE<8）（56% vs. 40%，p=0.01）。
急诊科有急性颈痛的 mTBI 患者构成了 mTBI 谱中具有特定损伤和人口统计学特征的一个特定群体。在急诊科早期识别这一高危人群可能允许进行特定的、及时的治疗，以避免不完全恢复的发生。
