Influencing Factors of Post-Concussion Syndrome Intensity in Patients with Mild Traumatic Brain Injury During One Month after the Trauma

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Sutthiphong Panthong
Niphawan Samartkit
Patchanok Witheethamsak

Abstract

Mild traumatic brain injuries can have a profound impact on a patient's quality of life . The purpose of this predictive descriptive research was to study factors influencing the intensity of post-concussion syndrome (PCS) in patients with mild traumatic brain injury (mTBI) 1 month after injury. Participants were 85 mTBI patients who were admitted to the neurological and trauma surgery ward in Chonburi Hospital . The research instruments included 1) the demographic and health status of patients with mild TBI record form, 2) the Rivermead Post Concussion Symptoms Questionnaire, and 3) the Verran and Snyder-Halpern Sleep Scale. Data were collected through the Application Line Official Account. Data were analyzed using descriptive statistics and multiple regression. The results revealed that sleep quality had the greatest influence on the intensity of PCS in mTBI patients 1 month after injury (β=-.55, p=.01), followed by the intensity of PCS at first admission (β=.29, p=.01). It was also found that gender, level of consciousness on first attendance at the emergency department, severity of PCS after the initial brain injury, and sleep quality could explain 54% of the variance in the intensity of PCS in mTBI patients 1 month after injury (adjusted R2=.54, p <.001). In conclusion, the findings of this study suggest that health care providers should be concerned about the importance of evaluating PCS continuously from the acute phase throughout one month in order to develop nursing intervention programs and effective treatment for preventing persistent PCS after traumatic brain injury.

Article Details

How to Cite
1.
Panthong S, Samartkit N, Witheethamsak P. Influencing Factors of Post-Concussion Syndrome Intensity in Patients with Mild Traumatic Brain Injury During One Month after the Trauma. NJPH (วารสาร พ.ส.) [internet]. 2024 Dec. 25 [cited 2025 Feb. 13];34(3):152-63. available from: https://he02.tci-thaijo.org/index.php/tnaph/article/view/272859
Section
บทความวิจัย

References

Esterov D, Bellamkonda E, Mandrekar J, Ransom JE, Brown AW. Cause of death after traumatic brain injury: a population-based health record review analysis referenced for nonhead trauma. Neuroepidemiology.

;55(3):180-7.

Dewan MC, Rattani A, Gupta S, Baticulon RE, Hung YC, Punchak M, et al. Estimating the global incidence of traumatic brain injury. Journal of Neurosurgery. 2018:1-18.

Di Pietro V, Yakoub KM, Caruso G, Lazzarino G, Signoretti S, Barbey AK, et al. Antioxidant therapies in traumatic brain injury. Antioxidants (Basel). 2020;9(3).

Dwyer B, Katz DI. Postconcussion syndrome 2018.

Paterno R, Folweiler KA, Cohen AS. Pathophysiology and treatment of memory dysfunction after traumatic brain injury. Current Neurology and Neuroscience Reports. 2017;17(7):52.

Eapen BC, Bowles AO, Sall J, Lang AE, Hoppes CW, Stout KC, et al. The management and rehabilitation of post-acute mild traumatic brain injury. Brain Injury. 2022;36(5):693-702.

Cnossen MC, van der Naalt J, Spikman JM, Nieboer D, Yue JK, Winkler EA, et al. Prediction of persistent post-concussion symptoms after mild traumatic brain injury. J Neurotrauma. 2018;35(22):2691-8.

Mehrolhassani N, Movahedi M, Nazemi-Rafi M, Mirafzal A. Persistence of post-concussion symptoms in patients with mild traumatic brain injury and no psychiatric history in the emergency department. Brain Injury. 2020;34(10):1350-7.

Varner C, Thompson C, de Wit K, Borgundvaag B, Houston R, McLeod S. Predictors of persistent concussion symptoms in adults with acute mild traumatic brain injury presenting to the emergency department. Canadian Journal of Emergency Medicine. 2021;23(3):365-73.

Wongchai N, Varitsakul R, Tantivesruangdet N. Factors associated with post-concussion syndrome in

patients eith mild traumatic brain injury after discharge from an emergency department. Nursing Journal.

;49(2):252-69.

Teshome AA, Ayehu GW, Yitbark GY, Abebe EC, Mengstie MA, Seid MA, et al. Prevalence of post-

concussion syndrome and associated factors among patients with traumatic brain injury at Debre Tabor

Comprehensive Hospital, North Central Ethiopia. Frontiers in Neurology. 2022;13:1056298.

Lenz ER, Pugh LC, Milligan RA, Gift A, Suppe F. The middle-range theory of unpleasant symptoms:

an update. Advance in Nursing Science. 1997;19(3):14-27.

Houck Z, Asken B, Bauer R, Clugston J. Predictors of post-concussion symptom severity in a university-

based concussion clinic. Brain Injury. 2019;33(4):480-9.

Fehr SD, Nelson LD, Scharer KR, Traudt EA, Veenstra JM, Tarima SS, et al. Risk factors for prolonged

symptoms of mild traumatic brain injury: a pediatric sports concussion clinic cohort. Clinical journal of

sport medicine. 2019;29(1):11-7.

Babcock L, Byczkowski T, Wade SL, Ho M, Mookerjee S, Bazarian JJ. Predicting postconcussion

syndrome after mild traumatic brain injury in children and adolescents who present to the emergency

department. JAMA Pediatrics. 2013;167(2):156-61.

Kowalczyk CL, Eagle SR, Holland CL, Collins MW, Kontos AP. Average symptom severity and related

predictors of prolonged recovery in pediatric patients with concussion. Applied Neuropsychology Child.

;11(2):145-9.

Durant E, Sporer KA. Characteristics of patients with an abnormal glasgow coma scale score in the

prehospital setting. Western Journal of Emergency Medicine. 2011;12(1):30-6.

Dikmen S, Machamer J, Temkin N. Mild traumatic brain injury: longitudinal study of cognition, functional

status, and post-traumatic symptoms. Journal of neurotrauma. 2017;34(8):1524-30.

Samartkit N, Wannasrithong A. A longitudinal study of headache, fatique, sleepdisturbance, and

performance in patients with mild head injury. Nursing Journal of The Ministry of Public Health.

;28(3):115-30.(in Thai)

Sullivan KA, Berndt SL, Edmed SL, Smith SS, Allan AC. Poor sleep predicts subacute postconcussion

symptoms following mild traumatic brain injury. Applied Neuropsychology: Adult. 2016;23(6):426-35.

Oyegbile TO, Dougherty A, Tanveer S, Zecavati N, Delasobera BE. High sleep disturbance and longer

concussion duration in repeat concussions. Behavioral Sleep Medicine. 2020;18(2):241-8.

Saksvik SB, Karaliute M, Kallestad H, Follestad T, Asarnow R, Vik A, et al. The prevalence and stability

of sleep-wake disturbance and fatigue throughout the first year after mild traumatic brain injury. Journal of

Neurotrauma. 2020;37(23):2528-41.

Cohen S. Perceived stress in a probability sample of the United States. The Social Psychology of Health.

:31-67.

King NS, Crawford S, Wenden FJ, Moss NEG, Wade DT. The Rivermead Post Concussion Symptoms

Questionnaire: a measure of symptoms commonly experienced after head injury and its reliability. Journal

of Neurology. 1995;242(9):587-92.

Premsai T. Follow up study of patient adaptation after mild head injury [dissertation].[Bangkok]: Mahidol

University; 2003.(in Thai)

Snyder Halpern R, Verran JA. Instrumentation to describe subjective sleep characteristics in healthy

subjects. Research in Nursing & Health. 1987;10(3):155-63.

Jitpanya C. Conceptual and measurement of sleep. Journal of Nursing Science Chulalongkorn University.

;12(1):1-9.

Kraemer Y, Mäki K, Marinkovic I, Nybo T, Isokuortti H, Huovinen A, et al. Post-traumatic headache

after mild traumatic brain injury in a one-year follow up study - risk factors and return to work. The Journal of Headache and Pain. 2022;23(1):27.

Schoenfeld R, Drendel A, Ahamed SI, Thomas D. Longitudinal assessment of acute concussion outcomes

through SMS Text (ConText Study). Pediatric Emergency Care. 2022;38(1):e37-e42.

Fatemeh G, Sajjad M, Niloufar R, Neda S, Leila S, Khadijeh M. Effect of melatonin supplementation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. Journal of Neurology. 2022;269(1):205-16.

Poza JJ, Pujol M, Ortega-Albás JJ, Romero O. Melatonin in sleep disorders. Neurologia (English Edition). 2022;37(7):575-85.

Bogdanov S, Naismith S, Lah S. Sleep outcomes following sleep-hygiene-related interventions for individuals with traumatic brain injury: A systematic review. Brain Injury. 2017;31(4):422-33.

Weymann KB, Rourke JM. Sleep after traumatic brain injury. Nursing Clinics of North America.

;56(2):275-86.

Hoffman NL, Weber ML, Broglio SP, McCrea M, McAllister TW, Schmidt JD. Influence of Postconcussion Sleep Duration on Concussion Recovery in Collegiate Athletes. Clin J Sport Med. 2020;30 Suppl 1:S29-s35.

Sullivan KA, Berndt SL, Edmed SL, Smith SS, Allan AC. Poor sleep predicts subacute postconcussion symptoms following mild traumatic brain injury. Applied Neuropsychology Adult. 2016;23(6):426-35.

Forrest RHJ, Henry JD, McGarry PJ, Marshall RN. Mild traumatic brain injury in New Zealand: factors influencing post-concussion symptom recovery time in a specialised concussion service. Journal of Primary Health Care. 2018;10(2):159-66.

Houck Z, Asken B, Bauer R, Clugston J. Predictors of post-concussion symptom severity in a university based concussion clinic. Brain Inj. 2019;33(4):480-9.

Lange RT, Brickell T, French LM, Ivins B, Bhagwat A, Pancholi S, et al. Risk factors for postconcussion symptom reporting after traumatic brain injury in U.S. military service members. Journal of Neurotrauma. 2013;30(4):237-46.

Sobut P, Phutthikhamin N. Factors predicting brain injury severity in the patients with traumatic brain injury. 2565;19(1):77-87.(in Thai)

Bootland D, Rose C, Barrett JW, Lyon R. Pre-hospital anaesthesia and assessment of head injured patients presenting to a UK Helicopter Emergency Medical Service with a high Glasgow Coma Scale: a cohort study. BMJ Open. 2019;9(2):e023307.