ArticleJournal of neurotrauma2022
Post-Concussion Symptoms Rule: Derivation and Validation of a Clinical Decision Rule for Early Prediction of Persistent Symptoms after a Mild Traumatic Brain Injury.
Article in Journal of neurotrauma, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Factors Associated With Persisting Symptoms After Concussion in Adults With Mild TBI: A Systematic Review and Meta-Analysis.JAMA network open · 2025Pooled it
- Patient-centered mild traumatic brain injury interventions in the emergency department.The American journal of emergency medicine · 2024Pooled it
- Updating Traumatic Brain Injury Classification for Surgeons: Integrating the CBI-M Framework Into Trauma and Acute Care Practice.World journal of surgery · 2026Review
- Symptom Resolution Characteristics: Initial Symptom Trajectories of Collegiate Students with and without Persisting Symptoms After Concussion.Sports medicine (Auckland, N.Z.) · 2026Article
- Longitudinal Multimodal Neuroimaging After Traumatic Brain Injury.Human brain mapping · 2026Article
- Stable serum peptidoglycan fragment levels do not support leaky gut in the acute phase or at one month following "mild" traumatic brain injury: A preliminary study.Brain, behavior, & immunity - health · 2026Article
- Use of In-Hospital Mild Traumatic Brain Injury Symptom Checklist Within 24 Hours of Injury to Predict 3-Month Symptom Outcome.The Journal of emergency medicine · 2026Article
- Observational
- Clinical Assessment on Days 1-14 for the Characterization of Traumatic Brain Injury: Recommendations from the 2024 NINDS Traumatic Brain Injury Classification and Nomenclature Initiative Clinical/Symptoms Working Group.Journal of neurotrauma · 2025Review
- Hair cortisol as a marker of stress in mild traumatic brain injury: a challenging measure.Scientific reports · 2025Article
- Symptom clusters and resting cardiovascular autonomic measures in adolescents: From acute concussion to recovery.Physiological reports · 2024Article
- Cause of Concussion With Persisting Symptoms Is Associated With Long-Term Recovery and Symptom Type, Duration, and Number in a Longitudinal Cohort of 600 Patients.Journal of neurotrauma · 2024Article
- Characterizing the profiles of patients with acute concussion versus prolonged post-concussion symptoms in Ontario.Scientific reports · 2023Article
- Prognostic Models for Global Functional Outcome and Post-Concussion Symptoms Following Mild Traumatic Brain Injury: A Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study.Journal of neurotrauma · 2023Article
- The performance ceiling: why clinical data is insufficient for precision prognosis in concussion.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
19 authors.
Funding
Abstract
Mild traumatic brain injury (mTBI) is a common problem. Depending on diagnostic criteria, 13 to 62% of those patients develop persistent post-concussion symptoms (PPCS). The main objective of this prospective multi-center study is to derive and validate a clinical decision rule (CDR) for the early prediction of PPCS. Patients aged ≥14 years were included if they presented to one of our seven participating emergency departments (EDs) within 24 h of an mTBI. Clinical data were collected in the ED, and symptom evolution was assessed at 7, 30 and 90 days post-injury using the Rivermead Post-Concussion Questionnaire (RPQ). The primary outcome was PPCS at 90 days after mTBI. A predictive model called the Post-Concussion Symptoms Rule (PoCS Rule) was developed using the methodological standards for CDR. Of the 1083 analyzed patients (471 and 612 for the derivation and validation cohorts, respectively), 15.6% had PPCS. The final model included the following factors assessed in the ED: age, sex, history of prior TBI or mental health disorder, headache in ED, cervical sprain and hemorrhage on computed tomography. The 7-day follow-up identified additional risk factors: headaches, sleep disturbance, fatigue, sensitivity to light, and RPQ ≥21. The PoCS Rule had a sensitivity of 91.4% and 89.6%, a specificity of 53.8% and 44.7% and a negative predictive value of 97.2% and 95.8% in the derivation and validation cohorts, respectively. The PoCS Rule will help emergency physicians quickly stratify the risk of PPCS in mTBI patients and better plan post-discharge resources.
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