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Appl Neuropsychol Adult. 2018 Mar-Apr;25(2):110-119. doi: 10.1080/23279095.2016.1248765. Epub 2016 Nov 17.

Assessment of acute head injury in an emergency department population using sport concussion assessment tool - 3rd edition.

Author information

1
a Division of Neurosurgery , Hennepin County Medical Center , Minneapolis , Minnesota , USA.
2
b Division of Neurosurgery , Minneapolis VA Health Care System , Minneapolis , Minnesota , USA.
3
c Department of Neurosurgery , University of Minnesota , Minneapolis , Minnesota , USA.
4
d Department of Neurosurgery , New York University School of Medicine , New York , New York , USA.
5
e Department of Surgery , Westchester Medical Center , Valhallah , New York , USA.
6
f Oculogica Inc. , New York , New York , USA.
7
g Ronald O. Perelman Department of Emergency Medicine , New York University School of Medicine , New York , New York , USA.
8
h Department of Surgery , New York University School of Medicine , New York , New York , USA.
9
i Department of Neurosurgery , Bellevue Hospital Center , New York , New York , USA.
10
j Neuropsychology Section (G8) , Hennepin County Medical Center , Minneapolis , Minnesota , USA.
11
k Departments of Neurology & Psychiatry , New York University School of Medicine , New York , New York , USA.

Abstract

Sport Concussion Assessment Tool version 3 (SCAT-3) is one of the most widely researched concussion assessment tools in athletes. Here normative data for SCAT3 in nonathletes are presented. The SCAT3 was administered to 98 nonathlete healthy controls, as well as 118 participants with head-injury and 46 participants with other body trauma (OI) presenting to the ED. Reference values were derived and classifier functions were built to assess the accuracy of SCAT3. The control population had a mean of 2.30 (SD = 3.62) symptoms, 4.38 (SD = 8.73) symptom severity score (SSS), and 26.02 (SD = 2.52) standardized assessment of concussion score (SAC). Participants were more likely to be diagnosed with a concussion (from among healthy controls) if the SSS > 7; or SSS ≤ 7 and SAC ≤22 (sensitivity = 96%, specificity = 77%). Identification of head injury patients from among both, healthy controls and body trauma was possible using rule SSS > 7 and headache or pressure in head present, or SSS ≤ 7 and SAC ≤ 22 (sensitivity = 87%, specificity = 80%). In this current study, the SCAT-3 provided high sensitivity to discriminate acute symptoms of TBI in the ED setting. Individuals with a SSS > 7 and headache or pressure in head, or SSS ≤ 7 but with a SAC ≤ 22 within 48-hours of an injury should undergo further testing.

KEYWORDS:

Brain concussion/diagnosis; emergency treatment/ classification; humans; mild traumatic brain injury/diagnosis; neuropsychological Tests/statistics and numerical data

PMID:
27854143
DOI:
10.1080/23279095.2016.1248765
[Indexed for MEDLINE]

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