Omair Jasmine, Alkin Victoria, Jaganathan Vaitheesh, Bjurström Martin F, Drazin Doniel, Sieg Emily, Friedland Robert P, Boakye Maxwell, Dietz Nicholas
University of Louisville School of Medicine, Louisville, KY, USA.
Department of Neurosurgery, University of Louisville, Louisville, KY, USA.
Sci Rep. 2025 Aug 12;15(1):29531. doi: 10.1038/s41598-025-13979-0.
While loss of consciousness (LOC) is a key factor in assessing head injuries, its impact on clinical outcomes, including persistent post-concussive symptoms, mental health disorders, quality of life, and neurodegeneration, remains unclear. This systematic review explores the association of LOC in Mild Traumatic Brain Injury (mTBI) with clinical outcomes such as mental health, quality of life, and risk of neurodegenerative diseases. Comprehensive systematic review methodology; two electronic databases (PubMed, Embase) were systematically searched from January 1990 to December 2024. Pooled odds ratios (OR) were obtained using a random effects model. A total of 595 studies were assessed with 30 trials meeting inclusion criteria. The presence of LOC is associated with worsened clinical outcomes including persistent post-concussive symptoms (OR 1.89, 95% CI: 1.59-2.25), post-traumatic stress disorder (OR 1.81, 95% CI: 1.54-2.12), depression (OR 2.69, 95% CI: 2.10-3.43), and overall health-related quality of life (OR 1.84, 95% CI: 1.49-2.26). These findings suggest that the role of LOC in the outcomes of mTBI supports a higher risk of poorer short and long-term outcomes. Future studies may investigate variation in post-mTBI sequelae among those with similar LOC timelines.
虽然意识丧失（LOC）是评估头部损伤的关键因素，但其对临床结局的影响，包括持续性脑震荡后症状、心理健康障碍、生活质量和神经退行性变，仍不明确。本系统评价探讨了轻度创伤性脑损伤（mTBI）中LOC与心理健康、生活质量和神经退行性疾病风险等临床结局之间的关联。采用全面的系统评价方法；从1990年1月至2024年12月对两个电子数据库（PubMed、Embase）进行了系统检索。使用随机效应模型获得合并优势比（OR）。共评估了595项研究，其中30项试验符合纳入标准。LOC的存在与临床结局恶化相关，包括持续性脑震荡后症状（OR 1.89，95%CI：1.59 - 2.25）、创伤后应激障碍（OR 1.81，95%CI：1.54 - 2.12）、抑郁症（OR 2.69，95%CI：2.10 - 3.43）以及总体健康相关生活质量（OR 1.84，95%CI：1.49 - 2.26）。这些发现表明，LOC在mTBI结局中的作用支持了短期和长期结局较差的更高风险。未来的研究可以调查具有相似LOC时间线的人群中mTBI后遗症的差异。
