Predicting Postconcussion Syndrome after Minor Traumatic Brain Injury

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Abstract
Background: Up to 50% of patients with minor traumatic brain injury (mTBI) develop postconcussion syndrome (PCS). A decision rule to stratify risk for PCS is needed. Objective: To identify mTBI patients at low and high risk of PCS by comparing the predictive values of variables generated by logistic regression (LR) and recursive partitioning (RP). Methods: This was a prospective, observational study of 69 mTBI patients aged >16 years presenting to the emergency department of a university teaching hospital. Minor TBI was defined as loss of consciousness 24 on the Hopkins Verbal Learning A (HVLA) (by LR) and in 9% of those injured in sports scoring >22 on HVLA (RP). High risk: PCS occurred in 89% of women scoring Conclusions: Despite the high incidence of PCS, we were able to identify a low‐risk subgroup with an average PCS risk of <10% and a high‐risk subgroup with a PCS risk of ∼90%. Combining results from LR and RP expanded the number of patients able to be classified as high/low risk. Prospective validation is necessary.

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