Baseline Predictors of Fatigue 1 Year After Mild Head Injury
Presented to the James W. Rae Scientific Day, Department of Physical Medicine and Rehabilitation, University of Michigan Health System, May 9, 2008, Ann Arbor, MI.
Abstract
de Leon MB, Kirsch NL, Maio RF, Tan-Schriner CU, Millis SR, Frederiksen S, Tanner CL, Breer ML. Baseline predictors of fatigue 1 year after mild head injury.
Objective
To compare reports of fatigue 12 months after minor trauma by participants with mild head injury (MHI) with those with other injury, and identify injury and baseline predictors of fatigue.
Design
An inception cohort study of participants with MHI and other nonhead injuries recruited from and interviewed at the emergency department (ED), with a follow-up telephone interview at 12 months.
Setting
Level II community hospital ED.
Participants
Participants (n=58) with MHI and loss of consciousness (LOC) of 30 minutes or less and/or posttraumatic amnesia (PTA) less than 24 hours, 173 with MHI but no PTA/LOC, and 128 with other mild nonhead injuries. Inclusion criteria: age 18 years or older, within 24 hours of injury, Glasgow Coma Scale score of 13 or higher, and discharge from the ED.
Interventions
Not applicable.
Main Outcome Measure
Medical Outcomes Study 36-Item Short-Form Health Survey Vitality subscale.
Results
Significant predictors of fatigue severity at 12 months were baseline fatigue, having seen a counselor for a mental health issue, medical disability, marital status, and in some stage of litigation. Injury type was not a significant predictor.
Conclusions
Fatigue severity 12 months after injury is associated with baseline characteristics and not MHI. Clinicians should be cautious about attributing persisting fatigue to MHI without comprehensive consideration of other possible etiologic factors.
Correspondence to Ned L. Kirsch, PhD, Dept of Physical Medicine and Rehabilitation, University of Michigan Health Systems, 355 Briarwood Circle, Ann Arbor, MI 48109-5742
Supported by the Centers for Disease Control (grant no. R49/CCR523223-01); the National Institutes of Health; the National Institute of Child Health and Human Development; and the National Center for Medical Rehabilitation Research (grant no. 5-T32-HD007422-17).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
ABSTRACT