Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA.
Department of Neurological Surgery, UT Southwestern Medical Center Dallas, TX, USA.
Clin Neuropsychol. 2023 Oct;37(7):1410-1427. doi: 10.1080/13854046.2022.2119165. Epub 2022 Sep 9.
Persisting concussion symptoms may adversely affect return to work and functioning in daily activities. This study compared adults who were initially evaluated < 30 days versus those evaluated ≥ 30 days following a concussion at a specialty concussion clinic to determine if delayed initial evaluation is associated with persisting symptoms during recovery. Participants (N = 205) 18 years of age and older who sustained a concussion and presented to a North Texas Concussion Registry (ConTex) clinic were evaluated at two time points: initial clinical visit and three-month follow-up. Participants provided medical history, injury related information, and completed the Sport Concussion Assessment Tool-5 Symptom Evaluation, Generalized Anxiety Disorder 7-item scale (GAD-7), and Patient Health Questionnaire (PHQ-8). Participants were divided into two groups: early and delayed evaluation (±30 days post injury). Number and severity of concussion symptoms were similar between both groups at their initial clinical visit. However, linear regression models showed that a delayed clinical evaluation was associated with a greater number and severity of concussion symptoms along with greater aggravation of symptoms from physical and cognitive activity at three-month follow-up. Individuals who sought care at specialty concussion clinics regardless of previous care 30 or more days following their injury reported more serious persisting concussion symptoms at three month follow-up than those who sought care sooner. Education to improve adults' recognition of concussions when they occur and obtaining earlier clinical evaluation may represent important opportunities in promoting better recovery and reducing persisting concussion symptoms.
持续的脑震荡症状可能会对重返工作岗位和日常活动的功能产生不利影响。本研究比较了在专门的脑震荡诊所接受初始评估<30 天和≥30 天的成年人，以确定延迟初始评估是否与恢复期间持续的症状有关。参与者（N=205）年龄在 18 岁及以上，因脑震荡到北德克萨斯脑震荡登记处（ConTex）诊所就诊，在两个时间点进行评估：初始临床就诊和三个月随访。参与者提供了病史、与损伤相关的信息，并完成了运动脑震荡评估工具-5 症状评估、广泛性焦虑症 7 项量表（GAD-7）和患者健康问卷（PHQ-8）。参与者分为两组：早期和延迟评估（±30 天伤后）。在初始临床就诊时，两组的脑震荡症状数量和严重程度相似。然而，线性回归模型显示，延迟临床评估与更多和更严重的脑震荡症状以及三个月随访时来自身体和认知活动的症状恶化有关。无论受伤后 30 天或更长时间是否接受过先前的治疗，到专门的脑震荡诊所就诊的个体在三个月随访时报告的持续脑震荡症状更严重。提高成年人对脑震荡的认识并尽早进行临床评估，可能是促进更好康复和减少持续脑震荡症状的重要机会。
