Mathieu Massé-Pelletier, Valérie Boucher, Natalie Le Sage, Xavier Neveu, Lynne Moore, Marcel Émond, Eric Mercier
{"title":"轻度创伤性脑损伤后老年人脑震荡后症状","authors":"Mathieu Massé-Pelletier, Valérie Boucher, Natalie Le Sage, Xavier Neveu, Lynne Moore, Marcel Émond, Eric Mercier","doi":"10.1097/HTR.0000000000001077","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Main objective: to estimate the prevalence of post-concussion symptoms (PPCS) in patients aged ≥55 years. Secondary objective: to identify the predictive factors associated with PPCS in this age group.</p><p><strong>Setting: </strong>Seven Canadian academic Level I and Level II trauma centers' emergency department (ED).</p><p><strong>Participants: </strong>356 patients aged ≥55 years consulting in the ED within 24 hours of a mild traumatic brain injury (TBI) between July 2013 and October 2016 were included in this study.</p><p><strong>Design: </strong>This is a planned sub-analysis of a prospective multicenter cohort study. Patients were identified in the ED by emergency physicians and research assistants. Participants were contacted via telephone for follow-up at 7, 30, and 90 days post-mild TBI. During these follow-ups, research assistants assessed PPCS using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). A modified Poisson regression assessed the association between PPCS and potential predictors.</p><p><strong>Main measures: </strong>The main outcome of this study was the presence of PPCS at 90 days, defined as the presence of spontaneously described severe (RPQ ≥1 symptom of 4 points, or 2 symptoms of 3 points), persistent symptoms that affect the patients' life.</p><p><strong>Results: </strong>PPCS at 90 days was observed in 16%, [95% CI 12.6-20.2] of our cohort, and most of those reporting PPCS were aged between 55 and 65 years (63.2%). We identified 4 variables associated with PPCS: cervical sprains (RR: 2.28, [95% CI 1.34-3.86], P < .01), female sex (RR: 3.12 [95% CI 1.90-5.12], P < .01), at least 3 different prescribed medications (RR: 1.68 [95% CI 1.02-2.76], P < .05) and age, which appeared to be protective (RR: 0.63 [95% CI 0.42-0.92], P < .01).</p><p><strong>Conclusion: </strong>Our results identified patient characteristics associated with PPCS that can be easily recognized in the ED, such as patient sex, the use of at least 3 different medications and the presence of cervical sprain. Early identification of older adults at higher risk of PPCS is important to optimize care and guide post-ED management.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Post-Concussion Symptoms in Older Adults Following a Mild Traumatic Brain Injury.\",\"authors\":\"Mathieu Massé-Pelletier, Valérie Boucher, Natalie Le Sage, Xavier Neveu, Lynne Moore, Marcel Émond, Eric Mercier\",\"doi\":\"10.1097/HTR.0000000000001077\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Main objective: to estimate the prevalence of post-concussion symptoms (PPCS) in patients aged ≥55 years. Secondary objective: to identify the predictive factors associated with PPCS in this age group.</p><p><strong>Setting: </strong>Seven Canadian academic Level I and Level II trauma centers' emergency department (ED).</p><p><strong>Participants: </strong>356 patients aged ≥55 years consulting in the ED within 24 hours of a mild traumatic brain injury (TBI) between July 2013 and October 2016 were included in this study.</p><p><strong>Design: </strong>This is a planned sub-analysis of a prospective multicenter cohort study. Patients were identified in the ED by emergency physicians and research assistants. Participants were contacted via telephone for follow-up at 7, 30, and 90 days post-mild TBI. During these follow-ups, research assistants assessed PPCS using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). A modified Poisson regression assessed the association between PPCS and potential predictors.</p><p><strong>Main measures: </strong>The main outcome of this study was the presence of PPCS at 90 days, defined as the presence of spontaneously described severe (RPQ ≥1 symptom of 4 points, or 2 symptoms of 3 points), persistent symptoms that affect the patients' life.</p><p><strong>Results: </strong>PPCS at 90 days was observed in 16%, [95% CI 12.6-20.2] of our cohort, and most of those reporting PPCS were aged between 55 and 65 years (63.2%). We identified 4 variables associated with PPCS: cervical sprains (RR: 2.28, [95% CI 1.34-3.86], P < .01), female sex (RR: 3.12 [95% CI 1.90-5.12], P < .01), at least 3 different prescribed medications (RR: 1.68 [95% CI 1.02-2.76], P < .05) and age, which appeared to be protective (RR: 0.63 [95% CI 0.42-0.92], P < .01).</p><p><strong>Conclusion: </strong>Our results identified patient characteristics associated with PPCS that can be easily recognized in the ED, such as patient sex, the use of at least 3 different medications and the presence of cervical sprain. 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引用次数: 0
摘要
目的：主要目的：评估≥55岁患者脑震荡后症状（PPCS）的患病率。次要目的：确定与该年龄组PPCS相关的预测因素。环境：七个加拿大学术一级和二级创伤中心急诊科（ED）。参与者：2013年7月至2016年10月期间，356例年龄≥55岁的轻度创伤性脑损伤（TBI）患者在24小时内就诊于急诊科。设计：这是一项前瞻性多中心队列研究的计划亚分析。患者由急诊医生和研究助理在急诊科确认。在轻度脑损伤后7、30和90天，通过电话与参与者联系进行随访。在这些随访期间，研究助理使用Rivermead脑震荡后症状问卷（RPQ）评估PPCS。修正泊松回归评估PPCS与潜在预测因子之间的关系。主要指标：本研究的主要结局为90天PPCS的存在，定义为存在自发描述的严重（RPQ≥1个症状4分，或2个症状3分），影响患者生活的持续症状。结果：在我们的队列中，有16% （95% CI 12.6-20.2）在90天出现PPCS，大多数报告PPCS的患者年龄在55 - 65岁之间（63.2%）。我们确定了与PPCS相关的4个变量：颈椎扭伤（RR: 2.28, [95% CI 1.34-3.86], P < 0.01），女性（RR: 3.12 [95% CI 1.90-5.12], P < 0.01），至少3种不同的处方药物（RR: 1.68 [95% CI 1.02-2.76], P < 0.05）和年龄，这似乎是保护性的（RR: 0.63 [95% CI 0.42-0.92], P < 0.01）。结论：我们的研究结果确定了与PPCS相关的患者特征，这些特征在ED中很容易识别，例如患者的性别、使用至少3种不同的药物以及是否存在颈椎扭伤。早期识别PPCS风险较高的老年人对于优化护理和指导ed后管理具有重要意义。
Post-Concussion Symptoms in Older Adults Following a Mild Traumatic Brain Injury.
Objective: Main objective: to estimate the prevalence of post-concussion symptoms (PPCS) in patients aged ≥55 years. Secondary objective: to identify the predictive factors associated with PPCS in this age group.
Setting: Seven Canadian academic Level I and Level II trauma centers' emergency department (ED).
Participants: 356 patients aged ≥55 years consulting in the ED within 24 hours of a mild traumatic brain injury (TBI) between July 2013 and October 2016 were included in this study.
Design: This is a planned sub-analysis of a prospective multicenter cohort study. Patients were identified in the ED by emergency physicians and research assistants. Participants were contacted via telephone for follow-up at 7, 30, and 90 days post-mild TBI. During these follow-ups, research assistants assessed PPCS using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). A modified Poisson regression assessed the association between PPCS and potential predictors.
Main measures: The main outcome of this study was the presence of PPCS at 90 days, defined as the presence of spontaneously described severe (RPQ ≥1 symptom of 4 points, or 2 symptoms of 3 points), persistent symptoms that affect the patients' life.
Results: PPCS at 90 days was observed in 16%, [95% CI 12.6-20.2] of our cohort, and most of those reporting PPCS were aged between 55 and 65 years (63.2%). We identified 4 variables associated with PPCS: cervical sprains (RR: 2.28, [95% CI 1.34-3.86], P < .01), female sex (RR: 3.12 [95% CI 1.90-5.12], P < .01), at least 3 different prescribed medications (RR: 1.68 [95% CI 1.02-2.76], P < .05) and age, which appeared to be protective (RR: 0.63 [95% CI 0.42-0.92], P < .01).
Conclusion: Our results identified patient characteristics associated with PPCS that can be easily recognized in the ED, such as patient sex, the use of at least 3 different medications and the presence of cervical sprain. Early identification of older adults at higher risk of PPCS is important to optimize care and guide post-ED management.
期刊介绍：
The Journal of Head Trauma Rehabilitation is a leading, peer-reviewed resource that provides up-to-date information on the clinical management and rehabilitation of persons with traumatic brain injuries. Six issues each year aspire to the vision of “knowledge informing care” and include a wide range of articles, topical issues, commentaries and special features. It is the official journal of the Brain Injury Association of America (BIAA).
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