Early intervention for patients at risk for persisting disability after mild traumatic brain injury: a randomized, controlled study

Brain Inj. 2013;27(3):318-24. doi: 10.3109/02699052.2012.750740.

Abstract

Study objective: To investigate the effect of an early intervention visit in addition to written information and treatment as usual for patients with an estimated high risk for persisting disability after a mild traumatic brain injury (MTBI).

Research design: Randomized controlled trial.

Methods: One hundred and seventy-three patients, aged 15-70 years with a Glasgow coma scale of 14-15 were included. All received written information about MTBI. Ninety-seven patients who reported three or more symptoms according to the rivermead post-concussion symptoms questionnaire (RPQ) at 10 days after the injury were considered as high-risk patients and were randomized to either early visit to a doctor or to treatment as usual (TAU); all patients including the 76 low-risk patients were followed-up at 3 months. Completion rate was 83%. Outcome measures included RPQ and the hospital anxiety and depression scale.

Results: RPQ symptoms decreased significantly in both randomized groups, but were not significantly different in the groups at 3 months. At 3 months, anxiety and depression scores did not differ between groups.

Conclusions: An early intervention, offered to patients with an estimated high risk for persisting disability, had no additional effect on symptom level at 3 months after MTBI as compared to TAU.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety / diagnosis
  • Anxiety / epidemiology
  • Anxiety / prevention & control*
  • Brain Concussion / complications*
  • Brain Concussion / epidemiology
  • Brain Concussion / therapy*
  • Depression / diagnosis
  • Depression / epidemiology
  • Depression / prevention & control*
  • Early Diagnosis
  • Early Medical Intervention*
  • Female
  • Glasgow Coma Scale
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Persons with Disabilities / statistics & numerical data*
  • Post-Concussion Syndrome / diagnosis
  • Post-Concussion Syndrome / epidemiology
  • Post-Concussion Syndrome / prevention & control*
  • Risk Factors
  • Surveys and Questionnaires
  • Sweden / epidemiology