Head Injury Echoes

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A new calculator can determine the risk of experiencing symptoms of a concussion months later.
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Most people recover from a concussion within a few weeks, however approximately 10-20% of people will experience symptoms for months.

A team from UHN has identified factors that can help predict the risk that someone who gets a concussion will continue to experience symptoms months later.

A concussion is a brain injury caused by a hit or jolt to the head, and it can manifest through a variety of symptoms, such as sensitivity to light, headaches, dizziness, confusion and more.

For most people, the symptoms go away within a few weeks. In 10-20% of people, symptoms will persist for months—when this happens, physicians refer to them as ‘prolonged post-concussion symptoms’.

A team led by KITE Senior Scientist Dr. Mark Bayley used concussion diagnosis and care data from the Ontario Concussion Cohort study to identify the risk of prolonged symptoms.

The data that the researchers analyzed included to information for over 587,000 adult Ontarians diagnosed with a concussion, then followed their use of the health care system for two years after being diagnosed. The researchers identified those with prolonged concussion symptoms as individuals who, after six months or more post-injury, attended two or more specialist visits—criteria that identified 13% of the patients in the database.

Their analysis found that pre-existing mental health conditions, such as bipolar disorder or personality disorder, older age and fifteen or more primary care visits per year before the concussion were risk factors for developing prolonged concussion symptoms.

Combining these and other risk factors into an overall score, the researchers created the Toronto Rehabilitation Institute Concussion Outcome Risk Determination and Rehab Recommendations (TRICORDRR) risk calculator tool, available online.

“The results of our study and the online tool enables physicians, who are seeing individuals who have experienced a concussion, to quickly and easily determine their risk of developing prolonged symptoms,” says Dr. Bayley.

“By identifying those at risk, we can better tailor treatment and concussion education to individual patients. We can also use the tool to reassure low-risk individuals that they are likely to experience positive outcomes,” he concludes.

This work was supported by the Ontario Neurotrauma Foundation, the UHN Foundation and ICES, which is funded by the Ontario Ministry of Health and Long-Term Care.

Langer LK, Alavinia SM, Lawrence DW, Munce SEP, Kam A, Tam A, Ruttan L, Comper P, Bayley MT. Prediction of risk of prolonged post-concussion symptoms: Derivation and validation of the TRICORDRR (Toronto Rehabilitation Institute Concussion Outcome Determination and Rehab Recommendations) score. PLoS Med. 2021 Jul 8. doi: 10.1371/journal.pmed.1003652.

Dr. Mark Bayley (L), senior author of the study and Senior Scientist at the KITE Research Institute; Laura Langer (R), a research analyst at UHN and first author of the study.