Post-concussion states: How do we improve our patients’ outcomes? An Australian perspective

Thomas, Elizabeth; Fitzgerald, Melinda; Cowen, Gill

doi:10.1177/2059700220960313

Cited by 7 publications

(6 citation statements)

References 27 publications

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“…It is estimated that more than 200 000 TBIs occur in Australia each year, of which the majority (∼80%) are mild in severity. 15 Both the incidence and proportion that are mild are likely to be higher, as many mild TBI cases are not recognized or reported. The current research has highlighted the challenges faced by individuals and organizations that do not have a clinical background but that play an important role in recognizing and responding to TBI.…”

Section: How the Work Has Aided Connectivity In Its Missionmentioning

confidence: 99%

What Happens Next? Traumatic Brain Injury in the Community

Bragge

Wright

Grundy

et al. 2022

Journal of Head Trauma Rehabilitation

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Traumatic brain injury (TBI) continues to substantially impact the lives of millions of people around the world annually. Community-based prevention and support of TBI are particularly challenging and underresearched aspects of TBI management. Ongoing cognitive, emotional, and other effects of TBI are not immediately obvious in community settings such as schools, workplaces, sporting clubs, aged care facilities, and support agencies providing homelessness or domestic violence support. This is compounded by a lack of guidance and support materials designed for nonmedical settings. Connectivity Australia, a not-for-profit organization promoting TBI awareness, research, and support, responded to this need by conducting a national survey and series of roundtables to deepen understanding of TBI awareness, challenges, and support needs across the community. The 48 survey respondents and 22 roundtable participants represented Australian departments of health; correctional services; homelessness and housing; Aboriginal and Torres Strait Islander health; community, school, and professional sports; allied healthcare and rehabilitation providers; insurance; and work health and safety. Three key themes were identified: Accessible, nationally consistent plain-language guidelines; Building research literacy; and Knowing your role in TBI identification and management. This commentary briefly describes these themes and their implications based on a publicly available full report detailing the study findings (www.connectivity.org.au/resources-for-researchers/connectivity-research).

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Section: How the Work Has Aided Connectivity In Its Missionmentioning

confidence: 99%

What Happens Next? Traumatic Brain Injury in the Community

Bragge

Wright

Grundy

et al. 2022

Journal of Head Trauma Rehabilitation

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“…Mild traumatic brain injury (mTBI) is increasingly recognised as a substantial public health problem, particularly in the sporting context, where repeated mTBI (rmTBI) is prevalent. At least 20% of the 3.2 million people worldwide that present to hospital each year experience persistent neuropsychological, cognitive, sleep or physical dysfunction [1], with those experiencing rmTBI at greater risk [2,3]. rmTBI is also associated with an increased risk of developing neurodegenerative diseases such as dementia and Parkinson's disease [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…These studies support the concept that changes to lipids and their metabolites in the blood may reflect disruptions to the structural integrity of lipid-rich cell membranes in the brain. Depending on their structure and function, lipids can be classified into two categories: (1) lipids that lack fatty acids (e.g., cholesterol and vitamins) and ( 2) fatty acid-containing lipids [9]. The latter class includes storage lipids (e.g., mono-, di-, and triacylglycerols) and membrane lipids such as glycerophospholipids (e.g., phosphatidylcholine, PC; phosphatidylethanolamine, PE; phosphatidylserine, PS; and phosphatidylinositol, PI) and sphingolipids (e.g., ceramide, sphingomyelin (SM) and glycosphingolipids).…”

Section: Introductionmentioning

confidence: 99%

Plasma Lipid Profiles Change with Increasing Numbers of Mild Traumatic Brain Injuries in Rats

et al. 2022

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Mild traumatic brain injury (mTBI) causes structural, cellular and biochemical alterations which are difficult to detect in the brain and may persist chronically following single or repeated injury. Lipids are abundant in the brain and readily cross the blood-brain barrier, suggesting that lipidomic analysis of blood samples may provide valuable insight into the neuropathological state. This study used liquid chromatography-mass spectrometry (LC-MS) to examine plasma lipid concentrations at 11 days following sham (no injury), one (1×) or two (2×) mTBI in rats. Eighteen lipid species were identified that distinguished between sham, 1× and 2× mTBI. Three distinct patterns were found: (1) lipids that were altered significantly in concentration after either 1× or 2× F mTBI: cholesterol ester CE (14:0) (increased), phosphoserine PS (14:0/18:2) and hexosylceramide HCER (d18:0/26:0) (decreased), phosphoinositol PI(16:0/18:2) (increased with 1×, decreased with 2× mTBI); (2) lipids that were altered in response to 1× mTBI only: free fatty acid FFA (18:3 and 20:3) (increased); (3) lipids that were altered in response to 2× mTBI only: HCER (22:0), phosphoethanolamine PE (P-18:1/20:4 and P-18:0/20:1) (increased), lysophosphatidylethanolamine LPE (20:1), phosphocholine PC (20:0/22:4), PI (18:1/18:2 and 20:0/18:2) (decreased). These findings suggest that increasing numbers of mTBI induce a range of changes dependent upon the lipid species, which likely reflect a balance of damage and reparative responses.

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“…Australia has a unique healthcare structure in which there are both public and private hospitals, as well as privately owned and operated primary care general practices and allied health practices. There is currently no centralised health information system or insurance scheme linking these healthcare settings [ 13 ], and thus it is not currently possible to obtain comprehensive incidence data for individuals who seek care for a mTBI outside of the hospital setting in Australia [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Healthcare choices following mild traumatic brain injury in Australia

Thorne

Markovic

Chih

et al. 2022

BMC Health Serv Res

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Background Accurate data on the types of healthcare people seek in the early stages following mild traumatic brain injury (mTBI) in Australia is lacking. We sought to investigate the types of healthcare people seek following mTBI, including seeking no care at all; ascertain the demographic, pre- and peri-injury factors, and symptom characteristics associated with the care that people access; and examine whether choice of care is associated with symptomatic recovery and quality of life. Methods An online retrospective survey of Australians aged 18 to 65 years who had experienced a self-reported ‘concussion’ (mTBI) within the previous 18 months. Types of healthcare accessed were investigated, as well as those who did not seek any care. Data were analysed using frequency and percentages, chi-squared tests and logistic regression models. Results A total of 201 respondents had experienced a self-reported ‘concussion’ but 21.4% of the respondents did not seek any care. Of the 183 respondents who sought healthcare, 52.5% attended a hospital Emergency Department, 41.0% attended a general practitioner and 6.6% accessed sports-based care. Compared to their counterparts, those who had a lower level of education (p = 0.001), had experienced previous mTBI (p = 0.045) or previous mental health issues (p = 0.009) were less likely to seek healthcare, whilst those who had experienced loss of consciousness (p = 0.014), anterograde (p = 0.044) or retrograde (p = 0.009) amnesia, and symptoms including drowsiness (p = 0.005), nausea (p = 0.040), and feeling slow (p = 0.031) were more likely to seek care. Those who did not seek care were more likely to recover within one month (AOR 4.90, 95%CI 1.51 – 15.89, p = 0.008), albeit the relatively large 95%CI warrants careful interpretation. Compared to seeking care, not seeking care was not found to be significantly associated with symptom resolution nor quality of life (p > 0.05). Conclusions This study provides unique insight into factors associated with healthcare utilisation in the early stages following mTBI, as well as outcomes associated with choice of care, including not seeking care. Delivering targeted community education on the signs and symptoms of mTBI, and the advantages of seeking care following injury is an important step forward in the management of this challenging condition.

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Post-concussion states: How do we improve our patients’ outcomes? An Australian perspective

Cited by 7 publications

References 27 publications

What Happens Next? Traumatic Brain Injury in the Community

What Happens Next? Traumatic Brain Injury in the Community

Plasma Lipid Profiles Change with Increasing Numbers of Mild Traumatic Brain Injuries in Rats

Healthcare choices following mild traumatic brain injury in Australia

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