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  • 1.
    Magnusson, Beatrice M.
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    Ahrenby, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Stålnacke, Britt-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Symptoms and disability after mild traumatic brain injury: a five-year follow-up2024Ingår i: Journal of Integrative Neuroscience, ISSN 0219-6352, E-ISSN 1757-448X, Vol. 23, nr 2, artikel-id 45Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Every year, many people suffer from traumatic brain injuries (TBI) with dramatic consequences for both the victim and their close relatives in the form of remaining lifelong symptoms and functional disabilities as a result.

    METHODS: This study evaluates the outcomes of 49 patients after mild TBI (mTBI) at follow-up after 5 years by using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) to assess post-TBI symptoms and the Glasgow Outcome Scale Extended (GOSE) to assess disability. The specific aim was to evaluate post-TBI characteristics concerning age, gender, pre-injury systemic disease, computed tomography (CT) result and additional TBIs.

    RESULTS: Almost eighty percent reported RPQ symptoms, the most common for both genders being fatigue (51%) and poor concentration (51%). Seventy-six percent had a good recovery, 18% moderate disability, while 6% reported severe disability. The number of symptoms was significantly correlated to the level of disability. All participants with severe disability had repeated mTBI. Only twenty-one percent reported that they received some form of rehabilitation intervention after their mTBI.

    CONCLUSIONS: Five years after suffering mTBI, patients reported high rates of symptoms and disabilities. Our findings suggest that tailored rehabilitation interventions should be designed to identify mTBI patients in need of early rehabilitation. This would result in minimized suffering for the individual and improved cost-effectiveness for society.

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  • 2.
    Magnusson, Beatrice M.
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    Isaksson, Emil
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    Koskinen, Lars-Owe D.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Neurovetenskaper.
    A prospective observational cohort study of traumatic brain injury in the northern region of Sweden2022Ingår i: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 36, nr 2, s. 191-198Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Generally, to map epidemiological and demographic features of patients with traumatic brain injury (TBI) in Umeå county, Sweden. Specifically, to evaluate the subjects needing a computed tomography (CT) of the head after suffering from TBI and frequencies of 1) intracranial lesions detected with CT, 2) need for neurosurgical intervention and 3) admission to hospital.

    METHODS: Patients with a suspected TBI, undergoing CT within 24 hours of arrival to hospital, were included in a database for evaluation.

    RESULTS: Out of 302 patients (63% male), 83% were GCS 13-15, 7% were GCS 9-12 and 10% were GCS <9. The frequency of abnormal CT findings was 23% in GCS 13-15, 67% in GCS 9-12 and 97% in GCS <9. Neurosurgical intervention was needed by 4% of those with GCS 13-15, 52% of those with GCS 9-12 and by 76% of those with GCS <9.

    CONCLUSIONS: Subjects with GCS 13-15  had higher frequencies of abnormal CT findings, need for neurosurgical intervention and hospital admission than previously reported. A similar trend was observed for patients with GCS 9-12, which can be of serious nature, with a higher frequency of need for neurosurgical intervention than previously described.

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  • 3.
    Magnusson, Beatrice M.
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    Koskinen, Lars-Owe D.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Neurovetenskaper.
    Classification and characterization of traumatic brain injuries in the northern region of sweden2024Ingår i: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 13, nr 1, artikel-id 8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Traumatic brain injury (TBI) is a common cause of death and disability, the incidence of which in northern Sweden is not fully investigated. This study classifies and characterize epidemiological and demographic features of TBIs in a defined population in Umeå county, Sweden. Specifically, to evaluate frequencies of (1) intracranial lesions detected with computed tomography (CT), (2) need for emergency intervention, and (3) hospital admission, in minimal, mild, moderate, and severe TBI, respectively.

    Methods: The data were gathered from 4057 TBI patients visiting our emergency room (ER) during a two-year period (2015–2016), of whom 56% were men and approximately 95% had minimal TBIs (Glasgow Coma Scale (GCS), score 15).

    Results: Of all injuries, 97.8% were mild (GCS 14–15), 1.7% were moderate (GCS 9–13), and 0.5% were severe (GCS < 9). CT scans were performed on 46% of the patients, with 28% being hospitalized. A high annual TBI incidence of 1350 cases per 100,000 citizens was found. The mortality rate was 0.5% with the majority as expected in the elderly group (>80 years).

    Conclusions: Minimal TBIs were not as mild as previously reported, with a relatively high frequency of abnormal CT findings and a high mortality rate. No emergency intervention was required in patients in the GCS 13–15 group with normal CT scans. These findings have implications for clinical practice in the ER with the suggestion to include biomarkers to reduce unnecessary CT scans.

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  • 4.
    Wågberg, Sophia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    Stålnacke, Britt-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Magnusson, Beatrice M.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    Gender and age differences in outcomes after mild traumatic brain injury2023Ingår i: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 12, nr 15, artikel-id 4883Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Many people who suffer traumatic brain injury (TBI) have long-term residual symptoms. This study evaluates post-TBI symptoms and disabilities seven to eight years after mild TBI (mTBI), with specific aims to evaluate gender and age differences, and whether repeated TBI leads to the deterioration of symptoms and function. Telephone interviews with 595 patients were conducted using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) to assess post-TBI symptoms, and the Glasgow Outcome Scale Extended (GOSE) was used to assess disability. Thirty-four percent reported post-concussion symptoms (40% of females and 29% of males). The symptom burden was higher in women than in men, and higher in patients with repeated TBI. The distribution of symptoms was similar for women and men. Women reported a significantly higher level of disability on GOSE; 31% had not returned fully to daily life, compared with 17% of men (p < 0.001), the biggest difference being in the age group of 25–49 years. Patients with repeated mTBI reported significantly lower scores on GOSE; 31% had not returned fully to daily life, compared with 21% of the single-TBI patients (p < 0.05). After mild TBI, one of three patients reported at least one post-TBI symptom. Women and individuals with repeated TBI presented a worse GOSE outcome. These findings have implications for clinical practice and research and should be taken into consideration when planning the rehabilitation and follow-up of mTBI patients. This also emphasises the importance of informing patients about post-concussion symptoms and when to seek healthcare.

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