Hogenbirk, R.N.M. (Rianne) (2018) Several pre- and post-injury factors are associated with unfavorable outcome after mild traumatic brain injury due to a bicycle related accident: an observational cohort study. thesis, Medicine.
Full text available on request.Abstract
Introduction Cycling is an important part of the Dutch culture. There are about 22.8 million bicycles in the Netherlands, which is 1.3 times as much as there are citizens. In the recent years a shifting from conventional bicycle use to bicycles with electric pedaling support (E-bike) has taken place. Research showed that after road traffic accidents E-bikers have more severe injuries and more often traumatic brain injury compared to conventional cyclists. Most patients sustain a mild traumatic brain injury (mTBI), defined as a GCS of 13-15, <24 hours posttraumatic amnesia (PTA) and/or <30 minutes loss of consciousness. Most of the patients recover completely from mTBI, but some keep having complaints. To evaluate follow-up and to help formulate preventive advices for cyclists it is useful to discover associated factors on recovery of mTBI after a bicycle accident. Methods This study is a retrospective cohort study of patients who were treated at the Trauma Department of the University Medical Center of Groningen after a bicycle-related accident between July 2014 and December 2017. Patients above the age of 18 with mTBI, were sent questionnaires regarding functional recovery, quality of life, depression and anxiety and posttraumatic complaints (Glasgow Outcome Scale Extended (GOS-E), EuroQuol5D-5L (EQ5D5L), Hospital Anxiety and Depression Scale (HADS), Post-traumatic Complaintslist (PTC)). Demographics and data concerning the injury were extracted from patients’ charts. Multiple variable linear regression analyses and an multivariable logistic regression analyses were performed for analyzing the results. Results A total of 268 patients were included whereof 98 patients responded on the questionnaires (response rate 37%). Multivariable linear and logistic regression analyses showed negative association with female gender, comorbidities (FCI), ISS, post-traumatic amnesia and E-bike use on functional recovery. Poor recovery on the GOS-E was, although not significant (p>0.05), associated with female gender, a shorter interval between the accident and followup and a higher ISS score. A lower score on the EQ5D-5L was statistically significant associated with female gender (p=0.004), comorbidities (p=0.05) and the use of an E-bike (p=0.03). Thereby female gender was significant associated with increased post-traumatic complaints (p=0.005) as well as the presence of PTA was, although not significant (p>0.05). Mood disorders according to the HADS were statistically significant associated with female gender and the use of an E-bike (p<0.05). Conclusion Several pre- and post-injury factors are associated with various components of unfavorable outcome after a bicycle related accident. E-bike use seemed significantly associated with a lower quality of life and the risk of the possibility of having an mood disorder.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisors: and Poos, Drs. H.P.A.M. trauma surgeon and Reininga, Dr. I.H.F.research coordinator and Naalt, Prof. Dr. J. van derneurologist and Wendt, Dr. K.W. trauma surgeon and Department: and Trauma Surgery, department of Surgery and Institution: University Medical Center Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:01 |
| Last Modified: | 25 Jun 2020 11:01 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2158 |
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