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Long-Term Outcomes of Patients Seeking Specialized Health Care for Persisting Postconcussion Symptoms After a Mild Head Injury

Year: 2026

Type: article

Abstract: OBJECTIVE: To examine long-term outcomes of persisting postconcussion symptoms (PPCS) after mild head injury in patients seeking specialist care. DESIGN: Longitudinal cohort study. Baseline interview at outpatient admission and follow-up interviews at 3, 6, 12, 18, 24, 30, 36, 48, and 60 months postinjury, and 5 years after outpatient admission. SETTING: Rehabilitation clinic. PARTICIPANTS: Patients (N=191) with PPCS after mild head injury over the past 5 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Symptoms assessed by Rivermead Postconcussion Symptoms Questionnaire, functioning via Glasgow Outcome Scale-Extended and return to full-time work. Linear and logistic mixed models with and without interaction terms evaluated outcomes over time, while within-subject change was assessed from participants' first to last assessments. RESULTS: The sample comprised 800 assessments (mean 4.2 [SD, 1.7] per participant). Patients were divided into groups by time from injury to outpatient admission (group 1: 0-3mo [n=44]; group 2: 3-6mo [n=54]; group 3: 6-12mo [n=47]; group 4: 12-24mo [n=26]; group 5: 24-60mo [n=20]). Although the groups had similar clinical characteristics at outpatient admission, their outcomes over time differed. Substantial symptom reduction and functional improvement were observed over time in groups 1-4, but not in group 5. Most symptom relief across groups occurred in the months after outpatient admission. CONCLUSIONS: In patients seeking care for PPCS, most exhibited improvement over time and worsening was rare. However, many still experienced symptoms years after outpatient admission, and outpatient admission ≥2 years postinjury was associated with significantly poorer outcomes.

Source: Archives of Physical Medicine and Rehabilitation

DOI: 10.1016/j.apmr.2026.03.018