Prevalence of Post-Concussion-Like Symptoms in the General Injury Population and the Association with Health-Related Quality of Life, Health Care Use, and Return to Work

Abstract

Little is known about post-concussion-like symptoms in the general injury population and the association of these symptoms with outcome after injury. This study aimed to assess the prevalence of post-concussion-like symptoms in a general injury population and describe the association between post-concussion syndrome (PCS) and health-related quality of life (HRQL), health care use, and return to work. In this longitudinal study of a cohort of injury patients, data were collected 6 and 12 months after their Emergency Department visit. Questionnaires included socio-demographics, health care utilization, return to work and the five-level version of the EuroQol five-dimensional descriptive system (EQ-5D-5L) to measure HRQL. The 12-month questionnaire included the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). In total, 282 (22.0%) of the 1282 patients met the criteria for PCS. Apart from the high prevalence of PCS in patients with head injuries (29.4%), a considerable proportion of non-head injury patients also had PCS (20.6%) a year after injury. Patients with PCS had lower HRQL, lower return to work rates, and higher health care utilization, compared to patients without PCS. This underlines the importance of developing strategies to prevent post-concussion-like symptoms among injury patients, raising awareness among patients and physicians on the occurrence of PCS, early detection of PCS in the general injury population, and development of strategies to optimize recovery in this group of injury patients, ultimately leading to lower the individual and economic burden of injury.

Depressive Symptoms in Individuals With Persistent Postconcussion Symptoms: A Systematic Review and Meta-Analysis

“…The etiology of PPCS is diverse and multifactorial, with prognosis varying between individuals . The treatment of PPCS remains inconclusive, given that symptoms following a concussion (eg, headache, irritability) are nonspecific and can be commonly reported in healthy individuals, as well as in clinical groups with health conditions unrelated to mTBI . To account for the complexity of PPCS presentation, reference standard guidelines for pediatric and adult populations recommend a comprehensive, interdisciplinary approach to treatment …”

Reference Values for the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) from General Population Samples in the United Kingdom, Italy, and The Netherlands

“…In addition, as reflected by the distribution of reference values, these symptoms are more prevalent in the general population subsamples with chronic health complaints. Some studies have shown that the occurrence of PCS is less TBI-specific [ 53 , 54 ] and more related to the premorbid health status of the affected individuals than to TBI [ 55 , 56 ]. Furthermore, individuals suffering from chronic health conditions may experience cognitive, emotional, and somatic symptoms comparable to PCS (e.g., chronic pains [ 21 ], depression [ 51 ], stroke and multiple sclerosis [ 57 ], etc.).…”

Die Begutachtung des leichten Schädel-Hirn-Traumas

“…[7,8,9]. Diese als postcommotionelles Syndrom (PCS) bezeichnete Symptomatik, insbesondere affektive Veränderungen und Fatigue, findet sich allerdings auch bei verunfallten Patient*innen ohne Hirnschädigung [10] sowie in der gesunden Allgemeinbevölkerung [11].…”