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Peer-reviewedCC BY 4.0PLOS One

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

  • Jacinta Thorne1
  • Jemma Keeves2
  • Aleksandra K. Gozt3
  • Gill Cowen4
  • Elizabeth Thomas5
  • Alexander Ring6
  • HuiJun Chih7
  • Caerwen Beaton8
  • Francesca Buhagiar9
  • Amanda Jefferson10
  • Melissa Papini11
  • Glenn Arendts12
16 more authors
  • Antonio Celenza13
  • Ben Smedley14
  • Sjinene Van Schalkwyk15
  • John Charles Iliff16
  • Nicole Ghedina17
  • Russell Young18
  • Monica Marton19
  • Suzanne Robinson20
  • Melissa Licari21
  • Dan Xu22
  • Stephen Honeybul23
  • Michael Bynevelt24
  • Carmela Pestell25
  • Daniel Fatovich26
  • Sarah C. Hellewell27
  • Melinda Fitzgerald
27 affiliations
  1. 1Curtin Medical Research Institute, Curtin University, Perth, Western Australia, Australia
  2. 2Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia
  3. 3School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
  4. 4School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  5. 5Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
  6. 6School of Population Health, Curtin University, Perth, Western Australia, Australia
  7. 7School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
  8. 8Institute for Immunology and Infectious Diseases, Murdoch University, Perth, Western Australia, Australia
  9. 9School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
  10. 10Discipline of Emergency Medicine, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
  11. 11Emergency Department, Fiona Stanley Hospital, Perth, Western Australia, Australia
  12. 12Emergency Department, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
  13. 13Emergency Department, Rockingham General Hospital, Perth, Western Australia, Australia
  14. 14Emergency Department, Joondalup Health Campus, Perth, Western Australia, Australia
  15. 15Emergency Department, St John of God Hospital Murdoch, Perth, Western Australia, Australia
  16. 16School of Medicine, The University of Notre Dame, Perth, Western Australia, Australia
  17. 17Royal Flying Doctor Service - Western Operations, Perth, Western Australia, Australia
  18. 18Emergency Medicine, Royal Perth Hospital, Perth, Western Australia, Australia
  19. 19Emergency Department, St John of God Midland Public Hospital, Perth, Western Australia, Australia
  20. 20Emergency Department, Albany Regional Hospital, Albany, Western Australia, Australia
  21. 21Emergency Department, Geraldton Regional Hospital, Geraldton, Western Australia, Australia
  22. 22Deakin Health Economics, Institute for Health Transformation, School of Health and Development, Deakin University, MelbourneVictoria, Australia
  23. 23The Kids Research Institute Australia, Perth, Western Australia, Australia
  24. 24The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
  25. 25Consultant Neurosurgeon, Sir Charles Gairdner Hospital, Royal Perth Hospital and Fiona Stanley Hospital, Perth, Western Australia, Australia
  26. 26The Neurological Intervention & Imaging Service of Western Australia, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
  27. 27Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, Western Australia, Australia
Open at sourcePDFDOICite

Abstract

Background: 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. Methods: 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. Results: 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. Conclusion: 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.

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Cite

BibTeXRIS
BibTeX
@article{thorne2026predicting,
  title = {{Predicting recovery outcomes following mild traumatic brain injury in an Australian community cohort: Results from the Concussion Recovery Study (CREST)}},
  author = {Jacinta Thorne and Jemma Keeves and Aleksandra K. Gozt and Gill Cowen and Elizabeth Thomas and Alexander Ring and HuiJun Chih and Caerwen Beaton and Francesca Buhagiar and Amanda Jefferson and Melissa Papini and Glenn Arendts and Antonio Celenza and Ben Smedley and Sjinene Van Schalkwyk and John Charles Iliff and Nicole Ghedina and Russell Young and Monica Marton and Suzanne Robinson and Melissa Licari and Dan Xu and Stephen Honeybul and Michael Bynevelt and Carmela Pestell and Daniel Fatovich and Sarah C. Hellewell and Melinda Fitzgerald},
  journal = {PLOS One},
  year = {2026},
  month = oct,
  doi = {10.1371/journal.pone.0339248},
  url = {https://doi.org/10.1371/journal.pone.0339248},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Predicting recovery outcomes following mild traumatic brain injury in an Australian community cohort: Results from the Concussion Recovery Study (CREST)
AU  - Jacinta Thorne
AU  - Jemma Keeves
AU  - Aleksandra K. Gozt
AU  - Gill Cowen
AU  - Elizabeth Thomas
AU  - Alexander Ring
AU  - HuiJun Chih
AU  - Caerwen Beaton
AU  - Francesca Buhagiar
AU  - Amanda Jefferson
AU  - Melissa Papini
AU  - Glenn Arendts
AU  - Antonio Celenza
AU  - Ben Smedley
AU  - Sjinene Van Schalkwyk
AU  - John Charles Iliff
AU  - Nicole Ghedina
AU  - Russell Young
AU  - Monica Marton
AU  - Suzanne Robinson
AU  - Melissa Licari
AU  - Dan Xu
AU  - Stephen Honeybul
AU  - Michael Bynevelt
AU  - Carmela Pestell
AU  - Daniel Fatovich
AU  - Sarah C. Hellewell
AU  - Melinda Fitzgerald
PY  - 2026
DA  - 2026/10/07
JO  - PLOS One
DO  - 10.1371/journal.pone.0339248
UR  - https://doi.org/10.1371/journal.pone.0339248
AB  - Background: 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. Methods: 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. Results: 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. Conclusion: 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.
SN  - 1932-6203
ER  -