Internationale Zeitschrift für Physikalische Medizin und Rehabilitation
Offener Zugang
ISSN: 2329-9096
ISSN: 2329-9096
Torgeir Hellstrom, Eirik Vikane, Jan Sture Skouen, Erik Bautz-Holter, Aasmund Roe and Cecilie Roe
Objective: This study sought to explore whether subgroups of patients with mild TBI could be identified by their symptom profile according to cluster analysis. We also investigated whether these clusters are uniquely associated with structural brain damage as well as their relationship to anxiety and depression, other health complaints, functioning and participation in work. Methods: This was a prospective cohort study of patients with mild TBI who were registered at baseline and 6-8 weeks after injury. Results: A total of 270 patients were included. K-mean cluster analyses were conducted to describe groups of subjects with similar profiles of responses to the Rivermead Post Concussion Symptoms Questionnaire (RPQ). The four-cluster solution revealed one cluster with a low level of symptoms (low), one with a generally high symptom level (high), one cluster characterised by a high level of symptoms regarding cognitive functions (cognitive) and one cluster with somatic and frustration dominating symptoms (somatic). No significant differences in symptom level (mean score on RPQ) were revealed between subjects with and without radiological findings on brain scans (p=0.34). The “high” cluster group scored significantly higher than clusters 1, 2 and 3 in terms of both depression and anxiety but significantly lower on the GOSE. Cluster 2 scored significantly lower for health complaints in comparison to the other clusters. Conclusion: Subgroups of patients with mild TBI could be identified according to their symptom profile using cluster analysis. Patients with minor symptoms had a reduced risk for a positive finding on CT or MRI, whereas the high symptom level group struggled to return to work and demonstrated high levels of anxiety, depression and disability.