A new Sinai Health System study demonstrates there is no difference in symptoms or recovery times between patients who received standard post-concussion discharge instructions developed by the Centre for Disease Control and those who did not. The findings indicate that the current post-concussion protocols given to patients may need to be reconsidered. The study, published in Academic Emergency Medicine, was led by Dr. Catherine Varner, an emergency room physician and Clinician Scientist at Sinai Health System’s Schwartz/Reisman Emergency Medicine Institute.
In the study, 118 patients entering Mount Sinai Hospital’s Schwartz/Reisman Emergency Centre with a concussion were divided into two groups. Only one group received the standard medical recommendation to refrain from physical and cognitive activities (such as reading, talking on the phone, watching TV and exercise) with a gradual return to regular activity. Follow ups were completed at two- and four-week intervals, and appropriate measures were taken to ensure the safety of all patients. It is one of the few studies that focused on an adult patient cohort who are not specifically athletes.
Head injury is a common presentation in North American emergency departments, and 85 per cent of these patients may have concussion symptoms. For most people, symptoms resolve within seven to 10 days. However, in about 15 to 25 per cent of cases, patients have ongoing issues, referred to as “postconcussive syndrome.” About 20 per cent of those who have postconcussive syndrome do not return to full-time work one year after the initial injury.
“I will continue to encourage patients to rest as needed and refrain from contact sports while they recover from a concussion, but the evidence does not support fully refraining from activity,” says Dr. Varner. “The study really tells us that we are still not effectively addressing those patients with postconcussive syndrome, and whether there is something that we can be doing to reduce risk upon discharge.”
This study comes out of research completed at Sinai Health System’s Schwartz/Reisman Emergency Medicine Institute (SREMI). First established in 2013, SREMI’s mandate is to change practice and improve patient care by conducting meaningful clinical research, and translating these results into practice through education.
“Our emergency department is often the gateway for patients into the health-care system. This study is an example of research that may impact care in emergency medicine, and therefore, impact the care we provide to patients throughout their health-care journey. Treating patients more effectively for concussions in emergency departments, for example, could mean, less resources needed in their future to treat its long term effects,” says Dr. Howard Ovens, Chief of the Schwartz/Reisman Emergency Centre. “This is exactly what the Schwartz/Reisman Emergency Medicine Institute is meant to do – conduct research that ultimately leads to evidence-based advances at the bedside.”
To read the full study, click here.
About Sinai Health System
Sinai Health System is comprised of Mount Sinai Hospital, Bridgepoint Active Healthcare, Lunenfeld-Tanenbaum Research Institute and Circle of Care. As an integrated health system, it delivers exceptional care from healthy beginnings to healthy aging, especially for people with specialized and complex health needs, in hospital, community and home. Sinai Health System discovers and translates scientific breakthroughs, develops practical health solutions, educates future clinical and scientific leaders and leads efforts to eliminate health inequities. Its Lunenfeld-Tanenbaum Research Institute ranks in the top ten biomedical research institutes in the world. Sinai Health System is a full affiliate of the University of Toronto. www.sinaihealthsystem.ca
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