Factors Associated With Persisting Symptoms After Concussion in Adults With Mild TBI
Notice bibliographique
Résumé
Importance: Up to 30% of individuals who sustain a mild traumatic brain injury (mTBI) develop persisting symptoms after concussion (PSAC). Identifying acute risk factors for PSAC can enhance clinical care in adults with concussion. Objective: To evaluate summary odds ratio (OR) estimates for acute factors associated with PSAC in adults with mTBI. Data Sources: For this systematic review and meta-analysis, a systematic search of Ovid MEDLINE, Embase, PsycINFO, CINAHL, SPORTDiscus, and the Cochrane Central Register of Clinical Trials (studies published from 1970 to February 15, 2024) and backward reference searching was performed on February 15, 2024. Search terms were mTBI, concussion, prognostic variables, predictors, and PSAC. Study Selection: Peer-reviewed studies in English that reported clinical factors collected within 1 month (≤28 days) of injury and associated with poor outcome, specifically PSAC, more than 1 month after concussion were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. Data Extraction and Synthesis: Independent extraction and quality assessment were performed by 2 author reviewers. Study characteristics and ORs were extracted using the Modified Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prognostic Factor Studies. Risk of bias was assessed using the Quality in Prognostic Studies tool. Three-level meta-analytic models examined factors associated with PSAC 1, 3, and 6 months after mTBI. Main Outcomes and Measures: Adjusted OR (AOR) estimates for the association of acute clinical measures with PSAC. Results: Thirty-four studies were reviewed; data were extracted from 15 studies (44.1%) included in the meta-analysis (592 406 adults with concussion; mean age, 29.3 years [range, 16-89 years]; 57.8% male). Acute concentration difficulty was associated with greatest odds of PSAC across all time points (AOR, 3.43 [95% CI, 1.85-6.36]). Medical history of anxiety and/or depression or of sleep disorders (AOR, 2.47 [95% CI, 1.62-3.78]) and clinical signs (loss of consciousness and amnesia; AOR, 1.90 [95% CI, 1.28-2.84]) were associated with increased odds of PSAC across all time points. At 1 month (AOR, 3.12 [95% CI, 1.43-6.82]) and 6 months (AOR, 26.81 [95% CI, 3.42-210.06]), difficulty concentrating was associated with greatest odds of PSAC, while medical history of anxiety and/or depression or of sleep disorders was associated with greatest odds of PSAC at 3 months (AOR, 2.92 [95% CI, 1.39-6.14]). Conclusions and Relevance: In this systematic review and meta-analysis, acute cognitive symptoms, medical history of anxiety and/or depression or of sleep disorders, and the presence of clinical signs (loss of consciousness and amnesia) were the factors associated with greatest odds of PSAC in adults across all time points. The findings suggest that evaluating specific acute symptoms and signs may contribute to the prognosis of PSAC in adults.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,003 | 0,000 |
| Bibliométrie | 0,000 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».