Influence of Combat Blast-Related Mild Traumatic Brain Injury Acute Symptoms on Mental Health and Service Discharge Outcomes
NAVAL HEALTH RESEARCH CENTER SAN DIEGO CA
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Assessment of acute mild traumatic brain injury mTBI symptoms after a combat blast could aid diagnosis and guide follow-up care. This study s purposes were to document acute mTBI symptoms following a combat blast and to examine associations between acute symptoms and mental health and service discharge outcomes. A retrospective cohort study was conducted of 1656 service personnel who experienced a combat blast-related mTBI in Iraq. Acute mTBI symptoms were ascertained from point-of-injury medical records. The associations between acute symptoms and posttraumatic stress disorder PTSD, postconcussion syndrome PCS, and type of service discharge were examined. Disability discharge occurred in 11, while 36 had a non-disability discharge and 52 had no recorded discharge. A PTSD and PCS diagnosis was made in 19 and 15 of the sample, respectively. The most common acute mTBI symptoms were headache 62.8, loss of consciousness LOC 34.5, and tinnitus 33.2. LOC was predictive of PTSD odds ratio OR 1.54 95 confidence interval CI 1.18, 2.00 and PCS OR 2.08 95 CI 1.56, 2.77, while altered mental status OR 1.53 95 CI 1.07, 2.17 and previous blast history OR 1.83 95 CI 1.15, 2.90 were also predictive of PCS. While no acute mTBI symptoms were associated with discharge outcomes, injury severity was associated with disability discharge. LOC after blast-related mTBI was associated with PTSD and PCS, and injury severity was predictive of disability discharge. The assessment of cognitive status immediately after a blast could assist in diagnosing mTBI and indicate a need for follow-up care.
- Medicine and Medical Research
- Military Forces and Organizations