Outpatient follow-up after mild traumatic brain injury: Results of the UPFRONT-study

Abstract

Outpatient follow-up after mild traumatic brain injury de Koning, M.E.; Scheenen, M.E.; van der Horn, Harm J.; Hageman, G.; Roks, G.; Yilmaz, T.; Spikman, Jacoba; van der Naalt, Joukje Link to publication in University of Groningen/UMCG research database Citation for published version (APA): de Koning, M. E., Scheenen, M. E., van der Horn, H. J., Hageman, G., Roks, G., Yilmaz, T., ... van der Naalt, J. (2017). Outpatient follow-up after mild traumatic brain injury: Results of the UPFRONT-study. Brain Injury, 31, 1102-1108. DOI: 10.1080/02699052.2017 Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. 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: Twothirds 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. ARTICLE HISTORY

Pre-injury Comorbidities Are Associated With Functional Impairment and Post-concussive Symptoms at 3- and 6-Months After Mild Traumatic Brain Injury: A TRACK-TBI Study

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Evaluation and Treatment of Mild Traumatic Brain Injury: The Role of Neuropsychology

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