Journal of Rehabilitation Medicine 51-1CompleteIssue | Page 38

Factors associated with persistent post-concussion symptoms
Table II. Summary statistics for each outcome measure
Mean (SD); [range; IQR] n
11.31 (11.73); [2–52; 2–15]
4.19 (8.98); [0–52; 0–4]
3.96 (3.88); [0–20; 1–6] 127 a
343
343
Physical Health 50.10 (8.57); [22–61; 46–57] Mental Health 52.99 (5.58); [28–70; 50–57] 331 b
331 b
Total RPQ PCS Score
RPQ Overall Score
HADS Anxiety Score
Quality of Life – SF-12
a
216 participants (63% of total sample) reported not experiencing any PCS
that were more of a problem than prior to their head injury.
b
12 participants did not complete SF-12.
SD: standard deviation; IQR: interquartile range; PSC: post-concussional
symptoms.
cumented in 49% of NET-Plus participants. The vast
majority (92.8%) had returned to employment, with
10.1% indicating a change in duties due to the head
injury, and 58.1% of those studying had returned to
study, with 9.7% indicating a change in enrolment.
Ninety-one percent of participants were discharged
home after presentation to the ED, 5.5% were admitted
to the ward, 2.9% were transferred to another hospital
for treatment, and 0.6% went into police custody. There
were 26.28% who reported pre-injury psychological
issues, 12.99% illicit drug use and 6.34% alcohol
problems pre-injury.
Of the 343 participants, 63.6% were in the NET trial
control group and 36.4% in the intervention group. Of
the 343, 28% said they could recall receiving informa-
tion about mTBI at discharge, 12.8% were unsure or
could not remember, and 59.2% indicated they did not
receive information at discharge. In the CHART (i.e.
medical) file, 39.9% of participants were documented
as having had information provided at discharge,
1.7% having no information provided, 5.5% where it
was deemed not applicable to provide information at
discharge from ED (e.g. in case of admission to the
ward), and in 52.8% of cases it was not recorded.
Table II shows mean scores on the RPQ, HADS
and SF-12. The percentage of participants reporting
novel post-injury PCS on the RPQ (mild, moderate or
severe) is shown in Fig. 1. Three or more symptoms
were reported by 18.7% of participants and 12.8% met
International Classification of Diseases 10 th (ICD-10)
symptom criteria for PCS.
Participants reporting novel mild-severe symp-
toms were compared with those reporting no novel
symptoms across 3 age groups. For the symptomatic
group, 39.4% were < 40, 44.4% 40–64, and 26.7% > 65
years. χ 2 analysis was significant, χ 2 (2, n = 343) = 8.6,
p = 0.014, with participants older than 65 years re-
porting fewer novel PCS.
There were 14.9% of participants who scored >7 on
the HADS Anxiety scale, indicating clinically signifi-
cant anxiety symptoms at follow-up, where 7.2% scored
as mild, 5.6% moderate and 2.1% were severe. Anxiety
was statistically significantly correlated with PCS after
35
Table III. Percentage of participants reporting symptoms following
receipt of information at discharge from emergency departments
  Did not report novel
PCS post-injury (%)
(n  = 216) Reported novel
PCS post-injury
(%) (n  = 127)
Received information
Unsure
Did not receive information 27.8
16.2
56 28.3
7.1
64.6
PSC: post-concussional symptoms.
adjusting for cluster, whereby higher anxiety was as-
sociated with greater reporting of persistent novel post-
injury PCS at follow-up (r = 0.52, p < 0.001, n = 343).
Quality of life on SF-12 was also significantly cor-
related with PCS, with lower mental health scores and
to a lesser extent physical health scores associated with
reporting of persistent PCS at follow-up (r = –0.49,
p < 0.001 and r = –0.24, p < 0.001, respectively, n = 331).
Table III shows the percentages of participants
who did and did not report novel mild–severe PCS
at follow-up according to whether they did or did not
report receiving information about mTBI and PCS at
discharge from ED. χ 2 analysis indicated that there was
a significant difference, χ 2 (2, n = 343) = 6.18, p = 0.046,
with a higher percentage of participants who reported
novel PCS post-injury indicating that they had not re-
ceived information about mTBI and PCS at discharge
from ED. Of participants unsure about whether they
received information, a higher proportion did not report
novel PCS.
Predicting symptom reporting at follow-up
Results of each of the models are presented in Table
IV. In Model 1 where demographic variables were en-
tered, age was a statistically significant predictor, with
younger age being associated with greater symptom
reporting at follow-up. In Model 2 where premorbid
Fig. 1. Percentage of patients reporting novel post-injury symptoms at
a mean of 7 months post-injury.
J Rehabil Med 51, 2019