Outpatient follow-up after mild traumatic brain injury: Results of the UPFRONT-study. (3rd July 2017)

• Record Type: Journal Article
• Authors: de Koning, M. E.; Scheenen, M. E.; van der Horn, H. J.; Hageman, G.; Roks, G.; Yilmaz, T.; Spikman, J. M.; van der Naalt, J.
• Is Part Of: Brain injury. Volume 31:Number 8(2017)
• Page Start: 1102
• Page End: 1108
• Publication Date: 2017-07-03
• Subjects: Mild traumatic brain injury -- follow-up -- hospital admission -- outcome -- guideline; Brain damage -- Periodicals; Brain -- Wounds and injuries -- Periodicals; Brain Injuries -- Periodicals; 617.481
• DOI: 10.1080/02699052.2017.1296193
• Languages: English
• ISSNs: 0269-9052

Abstract

ABSTRACT: Objective : To investigate outpatient follow-up after mild traumatic brain injury (mTBI) by various medical specialists, for both hospitalized and non-hospitalized patients, and to study guideline adherence regarding hospital admission. Methods : Patients ( n = 1151) with mTBI recruited from the emergency department received questionnaires 2 weeks ( n = 879), 3 months ( n = 780) and 6 months ( n = 668) after injury comprising outpatient follow-up by various health care providers, and outcome defined by the Glasgow Outcome Scale Extended (GOS-E) after 6 months. Results : Hospitalized patients (60%) were older (46.6 ± 19.9 vs. 40.6 ± 18.5 years), more severely injured (GCS <15, 50% vs. 13%) with more Computed Tomography (CT) abnormalities on admission (21% vs. 2%) compared to non-hospitalized patients ( p < 0.01) . Almost half of the patients visited a neurologist at the outpatient clinic within six months (60% of the hospitalized and 25% of the non-hospitalized patients (χ 2 = 67.10, p < 0.01)), and approximately ten per cent consulted a psychiatrist/psychologist. Outcome was unfavourable (GOS-E <7) in 34% of hospitalized and 21% of non-hospitalized patients (χ 2 = 11.89, p < 0.01). Conclusion : Two-thirds of all mTBI patients consult one or more specialists within six months after injury, with 30% having an unfavourable outcome. A quarter of non-hospitalized patients was seen at the outpatient neurology clinic, underling the importance of regular follow-up of mTBI patients irrespective of hospital admittance.