Journal of Rehabilitation Medicine 51-1CompleteIssue | Page 39

36
J. Ponsford et al.
psychological history/substance abuse variables were
entered, the presence of premorbid psychological is-
sues was a significant predictor of symptom reporting,
whereby the odds of reporting novel PCS at follow-up
in participants with these issues pre-morbidly were
2.75 times than those of participants without these
issues. In Model 3 where injury-related information
was entered, LOC was a statistically significant pre-
dictor, whereby the odds of reporting PCS at follow-
up in those who had LOC recorded were 1.94 times
than those for participants who did not have LOC.
Furthermore, those with unclear or not recorded LOC
reported novel PCS 2.52 times more than those with
no LOC. In Model 4 where recollection of receiving
discharge information was entered, it was found to be
a statistically significant predictor. Those who did not
recall receiving information at discharge reported PCS
2.65 times more than those who were unsure. However,
those who recalled receiving information at discharge
DISCUSSION
Table IV. Results from logistic regression models investigating predictors of novel
post-injury symptom reporting, controlling for initial intervention study group and
accounting for clustering of responses within emergency departments
OR
reported PCS 2.35 times more than those who were
unsure of receiving information.
In the final Model (i.e. Model 5), the presence of
pre-morbid psychological issues, LOC and receipt of
information were statistically significant predictors.
Participants reported PCS 2.99 times more if they
had pre-morbid psychological issues. If they had
experienced a LOC, they reported PCS 2 times more
than those who had not experienced a LOC; if LOC
was questionable, participants reported PCS 2.47
times more than those who had not experienced a
LOC. Participants who reported they did not receive
information reported PCS 2.34 times more than those
who were unsure. While participants who did recall
receiving information at discharge reported PCS 2
times more than those who were unsure, this did not
reach statistical significance in the final model.
p-value
Pseudo R 2 P for Model
95% CI
Model 1 a
Study group
Age
Sex (males) 1.17
0.98
1.53 0.625
0.001
0.081 Model 2 b
Study group
Psychological (absent)
Time post injury
Illicit (absent)
Alcohol (absent) 1.22
2.75
1.00
1.26
1.83 0.475
< 0.00
0.179
0.514
0.131 Model 3 a
Study group
GCS
LOCc (No) 1.14
0.78 0.658
0.675 0.65 to 1.99
0.25 to 2.45
Questionable 2.52 0.003 1.35 to 4.67
Yes
Other injuryd (Yes) 1.94 0.005 1.22 to 3.10
No 1.14 0.630 0.66 to 1.97
Undocumented 0.73 0.135 0.48 to 1.10
Model 4 a
Study group
1.12
Receipt of informatione (Unsure) 0.689 0.64 to 1.98
Yes 2.35 0.015 1.18 to 4.68
No 2.65 0.001 1.52 to 4.63
Model 5 a
Study group
Age
Psychological (absent)
LOC (No) 1.31
0.99
2.99 0.333
0.085
< 0.000 0.76 to 2.27
0.98 to 1.00
1.83 to 4.89
Questionable 2.47
0.02
0.0106
0.63 to 2.17
0.97 to 0.99
0.95 to 2.47
0.71
1.68
0.99
0.63
0.83
to
to
to
to
to
0.05 < 0.000
0.03 < 0.000
0.02 0.007
0.09 0.000
2.12
4.50
1.01
2.50
4.01
< 0.000 1.56 to 3.92
Yes
2.0
Receipt of information (Unsure) 0.029 1.07 to 3.71
Yes 2.01 0.080 0.92 to 4.40
No 2.34 0.006 1.27 to 4.30
In all models, the standard error was adjusted for clustering. Intervention group was also included
in all models to control for the intervention.
Number of observations: a 343; b 331; cComparison group is to those who reported no loss of
consciousness (LOC); dComparison group is to those who reported other injury; eComparison
group is to those who were unsure of whether they had received information in the emergency
department at discharge. OR: odds ratio; CI: confidence interval.
www.medicaljournals.se/jrm
The aims of this study were to document
outcome in terms of reported PCS, return
to employment/study, anxiety symptoms
and health-related quality of life and
identify factors associated with persistent
PCS in a series of uncomplicated mTBI
cases presenting to the ED and agreeing
to follow-up. Whilst 63% of participants
reported no persistent PCS at follow-up,
18.7% reported 3 or more symptoms
at follow-up, an average of 7 months
post-injury, and 12.8% met criteria for
an ICD-10 diagnosis of PCS. The most
common symptoms were fatigue, for-
getfulness, slowed thinking and sleep
disturbance, followed by lowered frus-
tration tolerance, irritability, depression,
headaches and dizziness. These patterns
of persisting symptoms are consistent
with those found in previous longitudinal
studies (4–6, 22, 37). Overall, however,
the rates of PCS were low compared with
many previous studies and the severity of
reported symptoms was generally in the
mild to moderate range. Rates of return
to employment or study were high, with
92.8% of those employed pre-injury still
working at follow-up, but only 60% of
pre-injury students studying at follow-up.
This may be partly explained by some
students having completed studies. Rates
of anxiety symptoms were low. Consis-
tent with previous studies (8, 10), there
was a statistically significant association