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LO46: Sex-based differences in concussion symptom reporting and self-reported outcomes in a general adult ED population

Published online by Cambridge University Press:  11 May 2018

L. A. Gaudet*
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, AB
L. Eliyahu
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, AB
J. Lowes
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, AB
J. Beach
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, AB
M. Mrazik
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, AB
G. Cummings
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, AB
S. Couperthwaite
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, AB
D. Voaklander
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, AB
B. H. Rowe
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, AB
*
*Corresponding author

Abstract

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Introduction: Patients with concussion frequently present to the emergency department (ED). Studies of athletes and children indicate that concussion symptoms are often more severe and prolonged in females compared with males. To-date, study of sex-based concussion differences in general adult populations have been limited. This study examined sex-based differences in concussion outcomes. Methods: Adult (>17 years) patients presenting to one of three urban EDs in Edmonton, Alberta with Glasgow coma scale score 13 within 72 hours of a concussive event were recruited by on-site research assistants. Follow-up calls at 30 and 90 days post ED discharge captured extent of PCS using the Rivermead Post-Concussion questionnaire (RPQ), effect on daily living activities measured by the Rivermead Head Injury Questionnaire (RHIQ), and overall health-related quality of life using the 12-item Short Form Health Survey (SF-12). Dichotomous and categorical variables were compared using Fishers exact test; continuous variables were compared using t-tests or Mann-Whitney tests, as appropriate. Results: Overall, 130/250 enrolled patients were female. The median age was 35 years; men trended towards being younger (median=32 years; IQR: 23, 45) than women (median=40 years; IQR: 22, 52). Compared to women, more men were single (56% vs 38% (p=0.007) and employed (82% vs 71% (p=0.055). Men and women experienced different injury mechanisms (p=0.007) with more women reporting injury due to a fall (44% vs 26%), while more men were injured at work (16% vs 7%) or due to an assault (11% vs. 3%). Men had a higher return to ED rate (13% vs. 5%; p=0.015). Women had higher RPQ scores at baseline (p<0.001) and 30-day follow-up (p=0.001); this difference was not significant by 90 days (p=0.099). While women reported on the RHIQ at 30 days that their injury affected their usual activities significantly more than men (Median=5, IQR: 0, 11 vs. median=0.5, IQR: 0.5, 7; p=0.004), both groups had similar scores on the SF-12 physical composite and mental composite scales at all three measurement points. Conclusion: In a general ED concussion population, demographic differences exist between men and women. Based on self-reported and objective outcomes, womens usual activities may be more affected by concussion and PCS than men. Further analysis of these differences is required in order to identify different treatment options and ensure adequate care and treatment of injury.

Type
Oral Presentations
Copyright
Copyright © Canadian Association of Emergency Physicians 2018