Teasdale T W, Engberg A
Psychological Laboratory, University of Copenhagen, Denmark.
BMJ. 1997 Sep 6;315(7108):569-72. doi: 10.1136/bmj.315.7108.569.
To establish how long cognitive dysfunction lasts after concussion, and the extent to which it may be a predisposing risk factor for concussion, by examining the prevalence of cognitive dysfunction among young men who have sustained concussion.
Observational study.
Denmark.
1220 young men who had been admitted to hospital for concussion between the ages of 16 and 24 (identified in a national register of admissions) and who had also been cognitively tested by the Danish conscription draft board.
Score on the draft board's cognitive screening test, dichotomised as dysfunctional or non-dysfunctional (20.4% of the general population of Danish men appearing before the draft board had a dysfunctional score).
700 of the 1220 men had been tested after sustaining concussion; 520 had been tested before concussion. Four (50%) of the eight men who were tested less than seven days after the injury had a dysfunctional score. Among groups of the remaining 692 men who were tested at later time points after injury, the rates were only marginally raised (range 21.4% to 26.5%) above the population level. Among men tested before injury, the rate of dysfunctional scores was higher (30.4% (158/520)). Apart from suggesting cognitive dysfunction as a risk factor for concussion, this higher proportion seems to relate to the fact that they were typically injured as young adults, whereas those men who were tested after concussion had more often been injured as adolescents. The relative risk for concussion in the presence of cognitive dysfunction is estimated to be 1.57 (95% confidence interval 1.32 to 1.86).
Cognitive dysfunction is not only a short term consequence of concussion but also a predisposing risk factor for concussion, more so for young adults than for adolescents.
通过研究遭受脑震荡的年轻男性中认知功能障碍的患病率，确定脑震荡后认知功能障碍持续的时间，以及其可能作为脑震荡诱发风险因素的程度。
观察性研究。
丹麦。
1220名年龄在16至24岁之间因脑震荡入院的年轻男性（从国家入院登记册中识别），他们也接受了丹麦征兵委员会的认知测试。
征兵委员会认知筛查测试的分数，分为功能障碍或无功能障碍（在征兵委员会面前的丹麦男性总人口中，20.4%的人测试分数为功能障碍）。
1220名男性中有700名在遭受脑震荡后接受了测试；520名在脑震荡前接受了测试。受伤后不到七天接受测试的八名男性中有四名（50%）测试分数为功能障碍。在受伤后其他时间点接受测试的其余692名男性组中，该比率仅略高于总体水平（范围为21.4%至26.5%）。在受伤前接受测试的男性中，功能障碍分数的比率更高（30.4%（158/520））。除了表明认知功能障碍是脑震荡的一个风险因素外，这个较高的比例似乎与他们通常是在成年时受伤这一事实有关，而那些在脑震荡后接受测试的男性更多是在青少年时期受伤。存在认知功能障碍时脑震荡的相对风险估计为1.57（95%置信区间1.32至1.86）。
认知功能障碍不仅是脑震荡的短期后果，也是脑震荡的诱发风险因素，对年轻成年人的影响比对青少年更大。
