Karen M Lau1, Erin Madden1, Thomas C Neylan1,2, Karen H Seal1,2,3, Shira Maguen1,2. 1. a San Francisco VA Medical Center , San Francisco , CA , USA. 2. b Department of Psychiatry. 3. c Department of Medicine , University of California, San Francisco , San Francisco , CA , USA.
Abstract
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.
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.
Authors: Vladislav Bugay; Eda Bozdemir; Fabio A Vigil; Sang H Chun; Deborah M Holstein; William R Elliott; Cassie J Sprague; Jose E Cavazos; David O Zamora; Gregory Rule; Mark S Shapiro; James D Lechleiter; Robert Brenner Journal: J Neurotrauma Date: 2019-10-21 Impact factor: 5.269
Authors: Brandon P Lucke-Wold; Aric F Logsdon; Linda Nguyen; Ahmed Eltanahay; Ryan C Turner; Patrick Bonasso; Chelsea Knotts; Adam Moeck; Joseph C Maroon; Julian E Bailes; Charles L Rosen Journal: Nutr Neurosci Date: 2016-10-05 Impact factor: 4.994
Authors: Cassandra L Pattinson; Pashtun Shahim; Patricia Taylor; Kerri Dunbar; Vivian A Guedes; Vida Motamedi; Chen Lai; Christina Devoto; Jordan Peyer; Michael J Roy; Jessica M Gill Journal: J Head Trauma Rehabil Date: 2020 Jan/Feb Impact factor: 3.117