Does routine follow up after head injury help? A randomised controlled trial

Area of Science:

• Neuroscience
• Trauma Care
• Public Health

Background:

• The Medical Disability Society recommended routine follow-up for all head injury patients.
• The effectiveness of this recommendation for all injury severities was previously unevaluated.

Purpose of the Study:

• To determine if routine follow-up for head injury patients impacts outcomes at six months.
• To assess the impact of early intervention on patients with varying head injury severity.

Main Methods:

• A randomized controlled trial involving 1156 patients aged 16-65 with head injuries.
• Patients received either standard care or early follow-up (7-10 days post-injury) with additional support.
• Outcomes, including post-concussion symptoms and daily activity changes, were assessed at six months using validated questionnaires.

Main Results:

• No significant overall difference in outcomes between the early follow-up and control groups.
• Subgroup analysis revealed significantly fewer difficulties in everyday activities for patients with moderate to severe head injuries in the early intervention group (P=0.03).
• A high loss to follow-up rate (59%) was observed across both groups.

Conclusions:

• Routine follow-up for all head injury patients is not supported by current evidence.
• Early follow-up appears beneficial for patients with moderate to severe head injuries.
• Further research is needed to address the needs of patients with less severe injuries and to refine follow-up strategies.