Predicting recovery outcomes following mild traumatic brain injury in an Australian community cohort: Results from the Concussion Recovery Study (CREST).

Authors

Jacinta Thorne, Jemma Keeves, Aleksandra K Gozt, Gill Cowen, Elizabeth Thomas, Alexander Ring, HuiJun Chih, Caerwen Beaton, Francesca Buhagiar, Amanda Jefferson, Melissa Papini, Glenn Arendts, Antonio Celenza, Ben Smedley, Sjinene Van Schalkwyk, John Charles Iliff, Nicole Ghedina, Russell Young, Monica Marton, Suzanne Robinson, Melissa Licari, Dan Xu, Stephen Honeybul, Michael Bynevelt, Carmela Pestell, Daniel Fatovich, Sarah C Hellewell, Melinda Fitzgerald

Published in

PloS one. Volume 21. Issue 10. Pages e0339248. Epub Oct 07, 2026.

Abstract

Most people recover well following mild traumatic brain injury (mTBI). However, some experience persisting post-concussion symptoms (PPCS) for months or years. Our aims were (i) to evaluate the presence and impact of PPCS on return to functional activities over a 12-month period; and (ii) identify pre-, peri- and post-injury factors predictive of PPCS in an Australian community-based cohort at 3- and 12-months.
Adults (18-65 years) with mTBI were assessed by telephone within 7 days post-injury to capture demographics, pre-injury health status, injury circumstances (including mechanism, site of head impact) and symptoms. The primary outcome measure was the presence of PPCS, measured with the Post-Concussion Symptom Scale (PCSS). Logistic regression identified predictors of PPCS at 3- and 12-months.
Of 232 participants, 49.7% had PPCS at 3-months and 45.6% at 12-months. Return to work was 96.7% at 3-months and 96.9% at 12-months, despite nearly 50% reporting PPCS. Participants with a high initial symptom burden (PCSS ≥30) were six times more likely to experience PPCS at 3-months (adjusted odds ratio [aOR] 6.17, 95% CI 2.63-14.46) and three times as likely to have PPCS at 12-months (aOR 2.70, 95% CI 1.01-7.23). Acute symptoms of "feeling slow" or "nervousness" predicted PPCS at 3-months (aOR 2.97 and 2.74, respectively), but not at 12-months.
Of those who completed follow-up, nearly half had persistent symptoms at 12-months, often continuing to work despite symptoms. High initial symptom severity and acute symptoms may help clinicians identify those needing early targeted follow-up to reduce the burden of PPCS.

PMID:
42842597
Bibliographic data and abstract were imported from PubMed on 08 Oct 2026.

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