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社区中脑震荡的识别与检测:对英国初级医疗保健的启示

Recognition and Detection of Concussion in the Community: Implications for Primary Care in the UK.

作者信息

Bhandari Sachin, Heron Neil

机构信息

Salford Royal NHS Foundation Trust, Salford, England (SB).

Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland (NH).

出版信息

Am J Lifestyle Med. 2025 May 4:15598276251337429. doi: 10.1177/15598276251337429.

Abstract

Concussion, a subset of traumatic brain injury, is prevalent in both adults and children and can result in a range of short-term and long-term symptoms that can significantly impair an individual's overall quality of life. Lifestyle factors, such as engaging in high-impact sports may increase the likelihood of sustaining a concussion. Recently, there has been a coordinated effort to raise awareness and educate the general public about the recognition, time-critical interventions, and the associated risks. In the United Kingdom (UK), new grassroots concussion guidance advocates the importance of suspected concussions being diagnosed by a healthcare professional. This will likely lead to an influx of patients presenting to primary care as well as to other medical practitioners, such as those in accident and emergency departments. This review examines and highlights the limitations of the current diagnostic tools available to clinicians in the community and primary care settings. It compares how UK concussion practice relates to concussion practice in the United States (US) and critiques their limitations. It proposes a standardised, computer-integrated tool tailored to the time constraints of UK primary care, pending validation and patient outcome data, to improve diagnostic consistency and efficiency.

摘要

脑震荡是创伤性脑损伤的一种类型,在成人和儿童中都很常见,可能会导致一系列短期和长期症状,严重影响个人的整体生活质量。生活方式因素,如从事高冲击力运动,可能会增加发生脑震荡的可能性。最近,各方协同努力提高公众意识,对公众进行关于脑震荡的识别、紧急干预措施以及相关风险的教育。在英国,新的基层脑震荡指南强调了由医疗专业人员诊断疑似脑震荡的重要性。这可能会导致大量患者前往基层医疗服务机构以及其他医疗从业者处就诊,如急诊科医生。本综述审视并强调了社区和基层医疗环境中临床医生目前可用诊断工具的局限性。它比较了英国脑震荡诊疗实践与美国脑震荡诊疗实践的情况,并对其局限性进行了批判。它提出了一种标准化的、计算机集成工具,该工具针对英国基层医疗的时间限制进行了定制,有待验证和患者预后数据支持,以提高诊断的一致性和效率。

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本文引用的文献

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Sport concussion assessment tool™ - 6 (SCAT6).运动性脑震荡评估工具™-6(SCAT6)。
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Trauma Surg Acute Care Open. 2022 Oct 19;7(1):e000929. doi: 10.1136/tsaco-2022-000929. eCollection 2022.
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Long-term post-concussion symptoms.长期脑震荡后症状。
Tidsskr Nor Laegeforen. 2022 Aug 17;142(12). doi: 10.4045/tidsskr.21.0713. Print 2022 Sep 6.

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