Post-Traumatic Amnesia Testing for Suspected Concussion in the Emergency Department: A Retrospective Study

Among patients discharged from the ED after mild traumatic brain injury (mTBI), 16%-25% experience post-concussive symptoms for up to 3 months after injury. However, the assessment of mTBI in the ED is variable. A common tool for the assessment of mTBI in Australia is the Abbreviated Westmead Post-Traumatic Amnesia Scale (A-WPTAS). The aim of this study was to report the proportion of patients who were detected to have post-traumatic amnesia (PTA) following a head injury and whether this varied by reported loss of consciousness (LOC), age, Glasgow Coma Scale (GCS) and mechanisms of injury.

This was a single-centre, retrospective cohort study. Data were extracted from patients' electronic medical records. All patients presenting to the ED between 1 January 2019 and 31 December 2021 with a head injury, documented results of A-WPTAS, and aged ≥ 18 years were included for analysis.

There were 6259 patients included, and 5746 (91.8%, 95% CI: 91.1%-92.5%) passed the A-WPTAS. -PTA was more frequent among patients who presented with GCS 13 or 14, male patients, those with low falls and presenting after hours. Among patients with documented LOC, the pass rate was 90.6% (95% CI: 88.8%-92.4%), and among those without LOC, it was 92% (95% CI: 91.3%-92.8%); p = 0.13.

PTA was detected in a small proportion of patients tested in the ED. PTA was associated with low initial GCS, but not with reported LOC. Among patients discharged from the ED, follow-up for persistent post-concussion symptoms is indicated.