Evidence map›Paper›PMID 33555602›Full record

Trial reportCJEM2021

Predictors of persistent concussion symptoms in adults with acute mild traumatic brain injury presenting to the emergency department.

Catherine Varner, Cameron Thompson, Kerstin de Wit, Bjug Borgundvaag, Reaves Houston, Shelley McLeod

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in CJEM, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07634393 (A Randomized Study of Intravenous Metoclopramide Versus Intravenous Acetaminophen for Acute Concussion Treatment), which is not on this map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07634393 phase4not yet recruitingnot on this mapstarted 2026, after this paper: background citation

A Randomized Study of Intravenous Metoclopramide Versus Intravenous Acetaminophen for Acute Concussion Treatment

TypeinterventionalSponsorMontefiore Medical CenterRan2026 to 2028Enrolled200ConditionsConcussion Post Syndrome, Head Trauma InjuryArmsMetoclopramide 10mg, Acetaminophen
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Catherine VarnerFaculty of Medicine, University of Toronto, Toronto, ON, Canada. catherine.varner@sinaihealth.ca.ORCID 0000-0002-9696-1329
Cameron ThompsonSchwartz/Reisman Emergency Medicine Institute, Toronto, ON, Canada.
Kerstin de WitFaculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Bjug BorgundvaagFaculty of Medicine, University of Toronto, Toronto, ON, Canada.
Reaves HoustonSchwartz/Reisman Emergency Medicine Institute, Toronto, ON, Canada.
Shelley McLeodFaculty of Medicine, University of Toronto, Toronto, ON, Canada.

Funding

ALTERNATIVE PATHWAYS OF T CELL ACTIVATIONK08AR002017 · NIAMS · VANDERBILT UNIVERSITY · PI BYRD, VICTOR M · 1998 to 2002
$348k
ANDROGEN REGULATION OF HUMAN SEBACEOUS GLANDSK08AR002018 · NIAMS · PENNSYLVANIA STATE UNIV HERSHEY MED CTR · PI THIBOUTOT, DIANE M. · 1997 to 2001
$225k
Canadian Association of Emergency Physicians VARNER 2017Workplace Safety and Insurance Board VARN2018
6 · The paper itself

Abstract

objectiveTo identify risk factors associated with persistent concussion symptoms in adults presenting to the emergency department (ED) with acute mild traumatic brain injury (TBI).

methodsThis was a secondary analysis of a randomized controlled trial conducted in three Canadian EDs whereby the intervention had no impact on recovery or healthcare utilization outcomes. Adult (18-64 years) patients with a mild TBI sustained within the preceding 48 h were eligible for enrollment. The primary outcome was the presence of persistent concussion symptoms at 30 days, defined as the presence of ≥ 3 symptoms on the Rivermead Post-concussion Symptoms Questionnaire.

resultsOf the 241 patients who completed follow-up, median (IQR) age was 33 (25 to 50) years, and 147 (61.0%) were female. At 30 days, 49 (20.3%) had persistent concussion symptoms. Using multivariable logistic regression, headache at ED presentation (OR: 7.7; 95% CI 1.6 to 37.8), being under the influence of drugs or alcohol at the time of injury (OR: 5.9; 95% CI 1.8 to 19.4), the injury occurring via bike or motor vehicle collision (OR: 2.9; 95% CI 1.3 to 6.0), history of anxiety or depression (OR: 2.4; 95% CI 1.2 to 4.9), and numbness or tingling at ED presentation (OR: 2.4; 95% CI 1.1 to 5.2), were found to be independently associated with persistent concussion symptoms at 30 days.

conclusionsFive variables were found to be significant predictors of persistent concussion symptoms. Although mild TBI is mostly a self-limited condition, patients with these risk factors should be considered high risk for developing persistent concussion symptoms and flagged for early outpatient follow-up.

Indexed as

Brain ConcussionPost-Concussion SyndromeAdultAnxietyCanadaEmergency Service, HospitalFemaleHumansMiddle AgedConcussionMild traumatic brain injuryPersistent concussion symptoms

Identifiers

PMID33555602

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.