Dretsch, M N; Kelly, M P; Coldren, R L; Parish, R V; Russell, M L
In: Journal of Neurotrauma, vol. 32, no. 16, pp. 1217–1222, 2015.
Abstract | Links | BibTeX | Tags: 2003-2011, acute disease, Adolescent, adult, amnesia, ANAM, Article, assessment of humans, Automated Neuropsychological Assessment Metrics, Blast injuries, blast injury, blunt trauma, brain concussion, clinical article, cognition, Cognition Disorders, cognitive screening, comparative study, complication, concussion mechanism, Demography, deployment, Female, follow up, health status, human, Humans, Iraq War, Male, middle aged, Military, Military Acute Concussion Evaluation, Military personnel, neuropsychological test, Neuropsychological Tests, soldier, unconsciousness, UNITED States, War, Young Adult
@article{Dretsch2015a,
title = {No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers},
author = {Dretsch, M N and Kelly, M P and Coldren, R L and Parish, R V and Russell, M L},
doi = {10.1089/neu.2014.3637},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
number = {16},
pages = {1217--1222},
abstract = {Seventy-one deployed U.S. Army soldiers who presented for concussion care due to either blast or blunt mechanisms within 72 h of injury were assessed using the Military Acute Concussion Evaluation, the Automated Neuropsychological Assessment Metrics (ANAM), traditional neuropsychological tests, and health status questionnaires. Follow-up ANAM testing was performed 10 d after initial testing (±5 d). Twenty-one soldiers were excluded: two for poor effort and 19 who had combined blast/blunt injuries. Of the remaining 50 male participants, 34 had blast injuries and 16 had blunt injuries. There were no statistically significant differences between blast injury and blunt injury participants in demographic, physical, or psychological health factors, concussive symptoms, or automated and traditional neurocognitive testing scores within 72 h post-injury. In addition, follow-up ANAM scores up to 15 d post-injury were not significantly different (available on 21 blast-injured and 13 blunt-injured subjects). Pre-injury baseline ANAM scores were compared where available, and revealed no statistically significant differences between 22 blast injury and eight blunt injury participants. These findings suggest there are no significant differences between mechanisms of injury during both the acute and subacute periods in neurobehavioral concussion sequelae while deployed in a combat environment. The current study supports the use of sports/mechanical concussion models for early concussion management in the deployed setting and exploration of variability in potential long-term outcomes. © Copyright 2015, Mary Ann Liebert, Inc.},
keywords = {2003-2011, acute disease, Adolescent, adult, amnesia, ANAM, Article, assessment of humans, Automated Neuropsychological Assessment Metrics, Blast injuries, blast injury, blunt trauma, brain concussion, clinical article, cognition, Cognition Disorders, cognitive screening, comparative study, complication, concussion mechanism, Demography, deployment, Female, follow up, health status, human, Humans, Iraq War, Male, middle aged, Military, Military Acute Concussion Evaluation, Military personnel, neuropsychological test, Neuropsychological Tests, soldier, unconsciousness, UNITED States, War, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Stone Jr., M E; Safadjou, S; Farber, B; Velazco, N; Man, J; Reddy, S H; Todor, R; Teperman, S
Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 1, pp. 147–151, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult
@article{StoneJr.2015,
title = {Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population},
author = {{Stone Jr.}, M E and Safadjou, S and Farber, B and Velazco, N and Man, J and Reddy, S H and Todor, R and Teperman, S},
doi = {10.1097/TA.0000000000000679},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {1},
pages = {147--151},
abstract = {BACKGROUND: Mild traumatic brain injury (mTBI) constitutes 75% of more than 1.5 million traumatic brain injuries annually. There exists no consensus on point-of-care screening for mTBI. The Military Acute Concussion Evaluation (MACE) is a quick and easy test used by the US Army to screen for mTBI; however, its utility in civilian trauma is unclear. It has two parts: a history section and the Standardized Assessment of Concussion (SAC) score (0-30) previously validated in sports injury. As a performance improvement project, our institution sought to evaluate the MACE as a concussion screening tool that could be used by housestaff in a general civilian trauma population. METHODS: From June 2013 to May 2014, patients 18 years to 65 years old with suspected concussion were given the MACE within 72 hours of admission to our urban Level I trauma center. Patients with a positive head computed tomography were excluded. Demographic data and MACE scores were recorded in prospect. Concussion was defined as loss of consciousness and/or posttraumatic amnesia; concussed patients were compared with those nonconcussed. Sensitivity and specificity for each respective MACE score were used to plot a receiver operating characteristic (ROC) curve. An ROC curve area of 0.8 was set as the benchmark for a good screening test to distinguish concussion from nonconcussion. RESULTS: There were 84 concussions and 30 nonconcussed patients. Both groups were similar; however, the concussion group had a lower mean MACE score than the nonconcussed patients. Data analysis demonstrated the sensitivity and specificity of a range of MACE scores used to generate an ROC curve area of only 0.65. CONCLUSION: The MACE showed a lower mean score for individuals with concussion, defined by loss of consciousness and/or posttraumatic amnesia. However, the ROC curve area of 0.65 highly suggests that MACE alone would be a poor screening test for mTBI in a general civilian trauma population. LEVEL OF EVIDENCE: Diagnostic study, level II. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M N; Kelly, M P; Coldren, R L; Parish, R V; Russell, M L
In: Journal of Neurotrauma, vol. 32, no. 16, pp. 1217–1222, 2015.
@article{Dretsch2015a,
title = {No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers},
author = {Dretsch, M N and Kelly, M P and Coldren, R L and Parish, R V and Russell, M L},
doi = {10.1089/neu.2014.3637},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
number = {16},
pages = {1217--1222},
abstract = {Seventy-one deployed U.S. Army soldiers who presented for concussion care due to either blast or blunt mechanisms within 72 h of injury were assessed using the Military Acute Concussion Evaluation, the Automated Neuropsychological Assessment Metrics (ANAM), traditional neuropsychological tests, and health status questionnaires. Follow-up ANAM testing was performed 10 d after initial testing (±5 d). Twenty-one soldiers were excluded: two for poor effort and 19 who had combined blast/blunt injuries. Of the remaining 50 male participants, 34 had blast injuries and 16 had blunt injuries. There were no statistically significant differences between blast injury and blunt injury participants in demographic, physical, or psychological health factors, concussive symptoms, or automated and traditional neurocognitive testing scores within 72 h post-injury. In addition, follow-up ANAM scores up to 15 d post-injury were not significantly different (available on 21 blast-injured and 13 blunt-injured subjects). Pre-injury baseline ANAM scores were compared where available, and revealed no statistically significant differences between 22 blast injury and eight blunt injury participants. These findings suggest there are no significant differences between mechanisms of injury during both the acute and subacute periods in neurobehavioral concussion sequelae while deployed in a combat environment. The current study supports the use of sports/mechanical concussion models for early concussion management in the deployed setting and exploration of variability in potential long-term outcomes. © Copyright 2015, Mary Ann Liebert, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Stone Jr., M E; Safadjou, S; Farber, B; Velazco, N; Man, J; Reddy, S H; Todor, R; Teperman, S
Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 1, pp. 147–151, 2015.
@article{StoneJr.2015,
title = {Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population},
author = {{Stone Jr.}, M E and Safadjou, S and Farber, B and Velazco, N and Man, J and Reddy, S H and Todor, R and Teperman, S},
doi = {10.1097/TA.0000000000000679},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {1},
pages = {147--151},
abstract = {BACKGROUND: Mild traumatic brain injury (mTBI) constitutes 75% of more than 1.5 million traumatic brain injuries annually. There exists no consensus on point-of-care screening for mTBI. The Military Acute Concussion Evaluation (MACE) is a quick and easy test used by the US Army to screen for mTBI; however, its utility in civilian trauma is unclear. It has two parts: a history section and the Standardized Assessment of Concussion (SAC) score (0-30) previously validated in sports injury. As a performance improvement project, our institution sought to evaluate the MACE as a concussion screening tool that could be used by housestaff in a general civilian trauma population. METHODS: From June 2013 to May 2014, patients 18 years to 65 years old with suspected concussion were given the MACE within 72 hours of admission to our urban Level I trauma center. Patients with a positive head computed tomography were excluded. Demographic data and MACE scores were recorded in prospect. Concussion was defined as loss of consciousness and/or posttraumatic amnesia; concussed patients were compared with those nonconcussed. Sensitivity and specificity for each respective MACE score were used to plot a receiver operating characteristic (ROC) curve. An ROC curve area of 0.8 was set as the benchmark for a good screening test to distinguish concussion from nonconcussion. RESULTS: There were 84 concussions and 30 nonconcussed patients. Both groups were similar; however, the concussion group had a lower mean MACE score than the nonconcussed patients. Data analysis demonstrated the sensitivity and specificity of a range of MACE scores used to generate an ROC curve area of only 0.65. CONCLUSION: The MACE showed a lower mean score for individuals with concussion, defined by loss of consciousness and/or posttraumatic amnesia. However, the ROC curve area of 0.65 highly suggests that MACE alone would be a poor screening test for mTBI in a general civilian trauma population. LEVEL OF EVIDENCE: Diagnostic study, level II. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Dretsch, M N; Kelly, M P; Coldren, R L; Parish, R V; Russell, M L
In: Journal of Neurotrauma, vol. 32, no. 16, pp. 1217–1222, 2015.
Abstract | Links | BibTeX | Tags: 2003-2011, acute disease, Adolescent, adult, amnesia, ANAM, Article, assessment of humans, Automated Neuropsychological Assessment Metrics, Blast injuries, blast injury, blunt trauma, brain concussion, clinical article, cognition, Cognition Disorders, cognitive screening, comparative study, complication, concussion mechanism, Demography, deployment, Female, follow up, health status, human, Humans, Iraq War, Male, middle aged, Military, Military Acute Concussion Evaluation, Military personnel, neuropsychological test, Neuropsychological Tests, soldier, unconsciousness, UNITED States, War, Young Adult
@article{Dretsch2015a,
title = {No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers},
author = {Dretsch, M N and Kelly, M P and Coldren, R L and Parish, R V and Russell, M L},
doi = {10.1089/neu.2014.3637},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
number = {16},
pages = {1217--1222},
abstract = {Seventy-one deployed U.S. Army soldiers who presented for concussion care due to either blast or blunt mechanisms within 72 h of injury were assessed using the Military Acute Concussion Evaluation, the Automated Neuropsychological Assessment Metrics (ANAM), traditional neuropsychological tests, and health status questionnaires. Follow-up ANAM testing was performed 10 d after initial testing (±5 d). Twenty-one soldiers were excluded: two for poor effort and 19 who had combined blast/blunt injuries. Of the remaining 50 male participants, 34 had blast injuries and 16 had blunt injuries. There were no statistically significant differences between blast injury and blunt injury participants in demographic, physical, or psychological health factors, concussive symptoms, or automated and traditional neurocognitive testing scores within 72 h post-injury. In addition, follow-up ANAM scores up to 15 d post-injury were not significantly different (available on 21 blast-injured and 13 blunt-injured subjects). Pre-injury baseline ANAM scores were compared where available, and revealed no statistically significant differences between 22 blast injury and eight blunt injury participants. These findings suggest there are no significant differences between mechanisms of injury during both the acute and subacute periods in neurobehavioral concussion sequelae while deployed in a combat environment. The current study supports the use of sports/mechanical concussion models for early concussion management in the deployed setting and exploration of variability in potential long-term outcomes. © Copyright 2015, Mary Ann Liebert, Inc.},
keywords = {2003-2011, acute disease, Adolescent, adult, amnesia, ANAM, Article, assessment of humans, Automated Neuropsychological Assessment Metrics, Blast injuries, blast injury, blunt trauma, brain concussion, clinical article, cognition, Cognition Disorders, cognitive screening, comparative study, complication, concussion mechanism, Demography, deployment, Female, follow up, health status, human, Humans, Iraq War, Male, middle aged, Military, Military Acute Concussion Evaluation, Military personnel, neuropsychological test, Neuropsychological Tests, soldier, unconsciousness, UNITED States, War, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Stone Jr., M E; Safadjou, S; Farber, B; Velazco, N; Man, J; Reddy, S H; Todor, R; Teperman, S
Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population Journal Article
In: Journal of Trauma and Acute Care Surgery, vol. 79, no. 1, pp. 147–151, 2015.
Abstract | Links | BibTeX | Tags: Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult
@article{StoneJr.2015,
title = {Utility of the Military Acute Concussion Evaluation as a screening tool for mild traumatic brain injury in a civilian trauma population},
author = {{Stone Jr.}, M E and Safadjou, S and Farber, B and Velazco, N and Man, J and Reddy, S H and Todor, R and Teperman, S},
doi = {10.1097/TA.0000000000000679},
year = {2015},
date = {2015-01-01},
journal = {Journal of Trauma and Acute Care Surgery},
volume = {79},
number = {1},
pages = {147--151},
abstract = {BACKGROUND: Mild traumatic brain injury (mTBI) constitutes 75% of more than 1.5 million traumatic brain injuries annually. There exists no consensus on point-of-care screening for mTBI. The Military Acute Concussion Evaluation (MACE) is a quick and easy test used by the US Army to screen for mTBI; however, its utility in civilian trauma is unclear. It has two parts: a history section and the Standardized Assessment of Concussion (SAC) score (0-30) previously validated in sports injury. As a performance improvement project, our institution sought to evaluate the MACE as a concussion screening tool that could be used by housestaff in a general civilian trauma population. METHODS: From June 2013 to May 2014, patients 18 years to 65 years old with suspected concussion were given the MACE within 72 hours of admission to our urban Level I trauma center. Patients with a positive head computed tomography were excluded. Demographic data and MACE scores were recorded in prospect. Concussion was defined as loss of consciousness and/or posttraumatic amnesia; concussed patients were compared with those nonconcussed. Sensitivity and specificity for each respective MACE score were used to plot a receiver operating characteristic (ROC) curve. An ROC curve area of 0.8 was set as the benchmark for a good screening test to distinguish concussion from nonconcussion. RESULTS: There were 84 concussions and 30 nonconcussed patients. Both groups were similar; however, the concussion group had a lower mean MACE score than the nonconcussed patients. Data analysis demonstrated the sensitivity and specificity of a range of MACE scores used to generate an ROC curve area of only 0.65. CONCLUSION: The MACE showed a lower mean score for individuals with concussion, defined by loss of consciousness and/or posttraumatic amnesia. However, the ROC curve area of 0.65 highly suggests that MACE alone would be a poor screening test for mTBI in a general civilian trauma population. LEVEL OF EVIDENCE: Diagnostic study, level II. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.},
keywords = {Adolescent, adult, aged, Alcoholic Intoxication, amnesia, Article, assessment of humans, brain concussion, Brain Injuries, clinical assessment tool, computer assisted tomography, Concussion screening, Confounding Factors (Epidemiology), controlled study, DATA analysis, Demography, diagnostic test accuracy study, Dizziness, emergency health service, Female, Head, headache, hospital admission, human, Humans, injury severity, irritability, major clinical study, Male, middle aged, mild traumatic brain injury, Military Acute Concussion Evaluation, military medicine, nausea and vomiting, predictive value, priority journal, quality control, receiver operating characteristic, ROC Curve, screening test, Sensitivity and Specificity, traumatic brain injury, unconsciousness, Urban Population, visual disorder, Young Adult},
pubstate = {published},
tppubtype = {article}
}