School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan (Mr Chung and Dr Chiu); Departments of Nursing (Mr Chung and Dr Liu) and Neurosurgery (Drs Wei, Wen, Lin, and Chen), Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan (Dr Wei); and Research Center of Sleep Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan (Dr Chiu).
J Head Trauma Rehabil. 2022;37(5):278-284. doi: 10.1097/HTR.0000000000000733. Epub 2021 Oct 25.
Postconcussion symptoms (PCSs) are common complaints reported by patients after a mild traumatic brain injury (TBI), and these symptoms may lower quality of life. Previous investigations have primarily focused on PCSs in children, adults, and athletes. The frequency, and risk factors, and effects of PCSs for older adults with mild TBIs are unclear.
To investigate the frequency and risk factors of PCSs, and investigate their effects on quality of life over time after mild TBI in older adults.
A prospective longitudinal study was performed. All participants were enrolled from the emergency department or neurosurgical outpatient clinics of a medical center. The measurement tools were the Rivermead Post-Concussion Symptoms Questionnaire and the Quality of Life after Traumatic Brain Injury. Measurements were performed on the seventh day, at the first month, and at the sixth month after the head injury. A generalized estimating equation model was used for data analyses.
One hundred and one older adults (mean age of 76.0 years) with mild TBIs with negative neuroimaging findings were included. Overall, 32.7%, 4%, and 15.8% of the sample reported PCS after 7 days, 1 month, and 6 months of head injury, respectively, revealing a U-shaped trend. We observed that comorbidity measured using the modified Charlson Comorbidity Index was associated with differences in PCSs ( P < .05). PCSs were an independent predictor of changes in postinjury quality of life ( P < .001).
The results indicate that PCS after a mild TBI in older adults is prevalent, even in the chronic phase after a TBI, and PCSs significantly affected the quality of life of our cohort. Therefore, to improve patient quality of life, healthcare providers should employ effective interventions to manage PCSs at different phases after a TBI.
脑震荡后症状（PCSs）是轻度创伤性脑损伤（TBI）后患者常见的主诉，这些症状可能会降低生活质量。既往研究主要集中在儿童、成人和运动员的 PCSs 上。轻度 TBI 后老年人 PCSs 的频率、危险因素及其对生活质量的影响尚不清楚。
调查轻度 TBI 后老年人 PCSs 的频率和危险因素，并研究其随时间推移对生活质量的影响。
进行了一项前瞻性纵向研究。所有参与者均来自一家医疗中心的急诊室或神经外科门诊。测量工具为 Rivermead 脑震荡后症状问卷和创伤性脑损伤后生活质量量表。分别在头部损伤后的第 7 天、第 1 个月和第 6 个月进行测量。使用广义估计方程模型进行数据分析。
共纳入 101 例头部影像学阴性的轻度 TBI 老年患者（平均年龄 76.0 岁）。总体而言，分别有 32.7%、4%和 15.8%的患者在头部损伤后 7 天、1 个月和 6 个月时报告有 PCS，呈现出 U 型趋势。我们观察到使用改良 Charlson 合并症指数测量的合并症与 PCSs 的差异有关（P<.05）。PCSs 是伤后生活质量变化的独立预测因子（P<.001）。
研究结果表明，轻度 TBI 后老年人的 PCS 很常见，甚至在 TBI 后慢性期也是如此，PCSs 显著影响了我们队列的生活质量。因此，为了提高患者的生活质量，医护人员应在 TBI 后不同阶段采取有效的干预措施来管理 PCSs。
