Highlights
- •Concussion is diagnosed commonly in the setting of major trauma to other body regions.
- •There was no association of concussion with long-term adverse outcomes, measured using the Glasgow Outcome Scale-Extended.
- •There was no association of concussion with long term anxiety and/or depression.
Abstract
Introduction
Concussion may be sustained in the setting of injuries to multiple body regions and
persistent effects of concussion may impact recovery. This project aimed to evaluate
the association between concussion and 6-month and 12-month functional outcomes in
survivors after major trauma.
Methods
This was a registry-based cohort study that included adult patients with major trauma
who presented to hospital between 01 Jan 2008 and 31 Dec 2017 and survived to hospital
discharge. We excluded patients presenting with a Glasgow Coma Scale score <13 and
those diagnosed with other intracranial injuries. Additionally, from the non-concussed
group, patients with fractured skull and/or face were excluded, with the assumption
that such patients may have had undiagnosed concussion. A good recovery was considered
for Glasgow Outcome Scale-Extended (GOS-E) scores of 7 or 8. In addition, we assessed
for patient reported anxiety and/or depression measured using the 3-level EuroQol
5 dimensions questionnaire. A modified mixed effects Poisson models with random intercepts
for participant was used to assess the association between concussion and outcome.
Results
There were 28,161 eligible patients and 12,822 met inclusion criteria. Concussion
was diagnosed in 1860 patients (14.5%; 95%CI: 13.9–15.1). There was no association
between concussion and good recovery at 12 months (aRR 1.05 (95%CI: 0.99–1.11). There
was no association between concussion and anxiety and/or depression at 12 months (aRR
1.03; 95%CI: 0.99–1.07).
Conclusions
Concussion was sustained among 14.5% of included patients in the setting of major
trauma but not associated with longer-term adverse outcomes using GOS-E. Concussed
patients did not report differential rates of anxiety and/or depression.
Keywords
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Article info
Publication history
Published online: July 29, 2022
Accepted:
July 27,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
