Archives of Physical Medicine and Rehabilitation
Review articleSystematic Review of the Prognosis After Mild Traumatic Brain Injury in Adults: Cognitive, Psychiatric, and Mortality Outcomes: Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis
Section snippets
Methods
The protocol registration, case definition, literature search, critical review strategy, and data synthesis are outlined in detail elsewhere7 and in this issue.8 Briefly, the electronic databases MEDLINE, PsycINFO, Embase, CINAHL, and SPORTDiscus were systematically searched from 2001 to 2012. Reference lists of all systematic reviews and meta-analyses related to MTBI and all articles meeting the eligibility criteria were checked to ensure that relevant studies were not missed.
Articles were
Results
Out of 77,914 records screened for our entire review, 2170 full-text articles were assessed for eligibility, 299 were critically reviewed, and 101 (ie, 34%) were deemed scientifically admissible (fig 1). This article presents the 21 accepted studies (all were published in English) reporting findings on course and prognostic factors associated with neuropsychological findings, psychiatric disorders, suicide subsequent to MTBI, mortality outcomes, and other objective outcomes. These studies form
Discussion
This review update of the course of recovery and prognostic factors expands on the WHO Collaborating Centre Task Force 2004 review and best evidence synthesis of MTBI.4 Overall, the evidence from both the current review and the 2004 review is consistent in suggesting the presence of initial cognitive deficits in adults after MTBI, although the nature of these deficits varies across studies, and there are no confirmatory (phase III) studies. This conclusion is consistent with the systematic
Conclusions
There is a substantial body of evidence suggesting that MTBI-related neuropsychological deficits are present during the first 2 weeks after an MTBI. However, there is less agreement in the literature on when these deficits resolve, and there is evidence from studies conducted over the last decade that some objectively measured cognitive deficits can last upward of 6 months. The certainty of this conclusion is limited by the small number of good quality studies examining this issue. There is
Acknowledgments
We thank the other members of the International Collaboration on MTBI Prognosis (ICoMP): Jean-Luc af Geijerstam, MD, PhD, Eleanor Boyle, PhD, Victor G. Coronado, MD, MPH, James Donovan, DC, Alison K. Godbolt, MBChB, MD, Ryan Hung, MD, MSc, Michelle Keightley, PhD, Alvin Li, BHSc, Connie Marras, MD, PhD, Peter Rumney, MD, and Britt-Marie Stålnacke, MD, PhD. We also thank Panos Lambiris, MSc, Information Scientist, University Health Network, for assisting in developing, testing, and updating the
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Supported by the Ontario Neurotrauma Foundation (grant no. 2010-ABI-MTBIWHO-871).
The funder was not involved in the design or preparation of the study protocol, or in the management of the project, analysis or interpretation of data, or the preparation of the final article.
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
The findings and conclusions in this research are those of the authors alone and do not necessarily represent the official views or policies of the Centers for Disease Control and Prevention or any agency of the United States government. Inclusion of individuals, programs, or organizations in this article does not constitute endorsement by the United States government.