Use of the Sports Concussion Assessment Tool 3 in Emergency Department Patients With Psychiatric Disease

被引:0
|
作者
Coscia, Atticus [1 ]
Stolz, Uwe [1 ]
Barczak, Christopher [1 ]
Wright, Natalie [2 ]
Mittermeyer, Stephan [2 ]
Shams, Tanzid [3 ]
Epstein, Stephen [4 ]
Kreitzer, Natalie [1 ,5 ]
机构
[1] Univ Cincinnati, Med Ctr, Dept Emergency Med, 231 Albert Sabin Way, Cincinnati, OH 45267 USA
[2] Jan Med, Mountain View, CA USA
[3] Ballad Hlth, Johnson City, TN USA
[4] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Dept Emergency Med, Boston, MA 02115 USA
[5] Univ Cincinnati, Med Ctr, Div Neurocrit Care, Cincinnati, OH 45267 USA
关键词
concussion assessment; emergency department; psychiatric disease; SCAT3; symptom evaluation; TRAUMATIC BRAIN-INJURY; PSYCHOMETRIC PROPERTIES; POSTCONCUSSION SYNDROME; SYMPTOMS; RECOVERY; DEPRESSION; PREDICTORS; DIAGNOSIS; SEVERITY; CHILDREN;
D O I
10.1097/HTR.0000000000000648
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: The Sports Concussion Assessment Tool 3 (SCAT3) Symptom Evaluation (SE) is used in the emergency department (ED). This study aimed to examine the effects of psychiatric history on the SCAT3 SE symptom severity score (SSS). Setting: Three US EDs. Participants: A total of 272 ED patients with suspected concussion. Design: Prospective, nonrandomized, nonblinded study. The SCAT3 SE SSS, demographic data, medical information, and self-reported psychiatric history were obtained from patients by clinical research staff when they presented to the ED seeking standard clinical care. Concussion diagnoses were determined following a comprehensive assessment by an ED physician trained in managing concussions and adjudicated by supervising physicians. Main Measures: The primary outcome measure was SSS. The association between SSS, self-reported psychiatric disease, and concussion diagnosis was analyzed using multivariable linear regression. Results: 68.4% of subjects were diagnosed with a concussion. After controlling for age, sex, race, history of previous concussion, and interval from injury to ED presentation, self-reported psychiatric history (adjusted regression coefficient (beta(a)): 16.9; confidence interval [CI]: 10.1, 23.6), and concussion diagnosis (beta(a): 21.7; CI: 14.2, 29.2) were both independently associated with a significant increase in SSS. Subjects with a history of concussion had a significantly higher SSS (beta(a): 9.1; CI: 1.8, 16.5). Interval from injury to ED presentation was also associated with a significant increase in SSS (beta(a): 1.6 per 6-hour increase; CI: 0.4, 2.8). Conclusion: Our findings demonstrate that a history of preexisting psychiatric disease, as self-reported by patients with a suspected concussion treated in the ED, is independently associated with significantly higher scores on the SCAT3 SE. This suggests that a history of psychiatric illness may need to be accounted for when the SCAT3 SE is used in the ED for the assessment of concussion.
引用
收藏
页码:E302 / E311
页数:10
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