Predicting outcome following mild traumatic brain injury: protocol for the longitudinal, prospective, observational Concussion Recovery (CREST) cohort study
Glenn Arendts,
Suzanne Robinson,
Gill Cowen,
Dan Xu,
Ashes Mukherjee,
Antonio Celenza,
Ben Smedley,
Michael Bynevelt,
Elizabeth Thomas,
Stephen Honeybul,
Aleksandra Karolina Gozt,
Sarah Claire Hellewell,
Jacinta Thorne,
Francesca Buhagiar,
Shaun Markovic,
Anoek Van Houselt,
Alexander Ring,
Sjinene Van Schalkwyk,
Philip Brooks,
John Iliff,
Melissa Licari,
Carmela F Pestell,
Daniel Fatovich,
Melinda Fitzgerald
Affiliations
Glenn Arendts
6 Emergency Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
Suzanne Robinson
Faculty of Health Sciences, Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
Gill Cowen
Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
Dan Xu
Medical Education, Sun Yan-sen University of Medical Sciences, Guangzhou, China
Ashes Mukherjee
12 Emergency Department, Armadale Kelmscott District Memorial Hospital, Armadale, Western Australia, Australia
Antonio Celenza
4 School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
Ben Smedley
13 Emergency Department, Rockingham General Hospital, Cooloongup, Western Australia, Australia
Michael Bynevelt
Sir Charles Gairdner Hospital, Nedlands, WA, Australia
Elizabeth Thomas
Division of Surgery, Faculty of Health & Medical Sciences, The University of Western Australia, Crawley, Western Australia, Australia
Stephen Honeybul
1 Department of Neurosurgery, Sir Charles Gairdner Hospital, Nedlands, Perth, Western Australia, Australia
Aleksandra Karolina Gozt
Curtin Health Innovation Research Institute, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
Sarah Claire Hellewell
Curtin Health Innovation Research Institute, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
Jacinta Thorne
Curtin Health Innovation Research Institute, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
Francesca Buhagiar
School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
Shaun Markovic
Australian Alzheimers Research Foundation, Nedlands, Western Australia, Australia
Anoek Van Houselt
School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
Alexander Ring
Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia
Sjinene Van Schalkwyk
Emergency Department, Joondalup Health Campus, Joondalup, Western Australia, Australia
Philip Brooks
Curtin Medical School, Curtin University, Bentley, Western Australia, Australia
John Iliff
Curtin Medical School, Curtin University, Bentley, Western Australia, Australia
Melissa Licari
School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
Carmela F Pestell
Curtin Health Innovation Research Institute, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
Daniel Fatovich
Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Nedlands, Western Australia, Australia
Melinda Fitzgerald
Curtin Health Innovation Research Institute, Curtin University Faculty of Health Sciences, Perth, Western Australia, Australia
Introduction Mild traumatic brain injury (mTBI) is a complex injury with heterogeneous physical, cognitive, emotional and functional outcomes. Many who sustain mTBI recover within 2 weeks of injury; however, approximately 10%–20% of individuals experience mTBI symptoms beyond this ‘typical’ recovery timeframe, known as persistent post-concussion symptoms (PPCS). Despite increasing interest in PPCS, uncertainty remains regarding its prevalence in community-based populations and the extent to which poor recovery may be identified using early predictive markers.Objective (1) Establish a research dataset of people who have experienced mTBI and document their recovery trajectories; (2) Evaluate a broad range of novel and established prognostic factors for inclusion in a predictive model for PPCS.Methods and analysis The Concussion Recovery Study (CREST) is a prospective, longitudinal observational cohort study conducted in Perth, Western Australia. CREST is recruiting adults aged 18–65 from medical and community-based settings with acute diagnosis of mTBI. CREST will create a state-wide research dataset of mTBI cases, with data being collected in two phases. Phase I collates data on demographics, medical background, lifestyle habits, nature of injury and acute mTBI symptomatology. In Phase II, participants undergo neuropsychological evaluation, exercise tolerance and vestibular/ocular motor screening, MRI, quantitative electroencephalography and blood-based biomarker assessment. Follow-up is conducted via telephone interview at 1, 3, 6 and 12 months after injury. Primary outcome measures are presence of PPCS and quality of life, as measured by the Post-Concussion Symptom Scale and the Quality of Life after Brain Injury questionnaires, respectively. Multivariate modelling will examine the prognostic value of promising factors.Ethics and dissemination Human Research Ethics Committees of Royal Perth Hospital (#RGS0000003024), Curtin University (HRE2019-0209), Ramsay Health Care (#2009) and St John of God Health Care (#1628) have approved this study protocol. Findings will be published in peer-reviewed journals and presented at scientific conferences.Trial registration number ACTRN12619001226190.
