Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors

作者：Lau Karen M^*; Madden Erin; Neylan Thomas C; Seal Karen H; Maguen Shira

来源：Brain Injury, 2016, 30(3): 287-294.

DOI：10.3109/02699052.2015.1089601

• veterans
• injury severity markers
• nausea
• neurologic symptoms
• Traumatic brain injury

Objective: To investigate injury severity markers and neurological symptoms associated with clinician-confirmed mild traumatic brain injury (TBI) among Iraq and Afghanistan veterans.
Setting: Department of Veterans Affairs (VA) medical centre and five affiliated community-based outpatient clinics.
Participants: Three hundred and fifty Iraq and Afghanistan veterans with positive initial VA TBI screens between 1 April 2007 and 1 June 2010 and clinician-confirmed TBI status by 1 December 2010.
Methods: Retrospective-cohort study of medical record data. Main measures included clinician-confirmed TBI status, injury severity markers (e.g. loss of consciousness (LOC), post-traumatic amnesia (PTA) or confusion/disorientation) and neurological symptoms.
Results: Among veterans who screened positive on the initial VA TBI and then received a clinician evaluation, 60% were confirmed to have a TBI diagnosis. Veterans reporting at least one LOC, confusion or PTA were almost 18-times more likely to receive a confirmed TBI diagnosis. Odds of clinician-confirmed TBI were 2.5-3-times greater among those who endorsed dizziness, poor coordination, headaches, nausea, vision problems and/or irritability, compared to those not endorsing these symptoms. Nausea had greatest utility for confirming a TBI.
Conclusions: Identification of neurologic symptoms that most contribute to a clinician-confirmed diagnosis of TBI has potential for streamlining detection of TBI and symptoms needed for treatment.

• 出版日期2016-2-23