Original Contribution Health status, not head injury, predicts concussion symptoms after minor injury B Samuel A. McLean MD, MPH a, ⁎ , Ned L. Kirsch PhD c , Cheribeth U. Tan-Schriner PhD g , Ananda Sen PhD e , Shirley Frederiksen RN, MS b , Richard E. Harris PhD d , William Maixner DDS, PhD h , Ronald F. Maio DO, MS b,f a Emergency Medicine and the TRYUMPH Research Program, University of North Carolina, Chapel Hill, NC 27599, USA b Emergency Medicine, University of Michigan Medical Center, Ann Arbor, MI 48109, USA c Physical Medicine and Rehabilitation, University of Michigan Medical Center, Ann Arbor, MI 48109, USA d Internal Medicine, University of Michigan Medical Center, Ann Arbor, MI 48109, USA e Center for Statistical Consulting and Research, University of Michigan Medical Center, Ann Arbor, MI 48109, USA f Injury Research Center, University of Michigan Medical Center, Ann Arbor, MI 48109, USA g Michigan Public Health Institute, Okemos, MI 48864, USA h Center for Neurosensory Disorders, University of North Carolina, Chapel Hill, NC 27599, USA Received 18 January 2008; accepted 28 January 2008 Abstract Objective: Postconcussion (PC) syndrome etiology remains poorly understood. We sought to examine predictors of persistent PC symptoms after minor injury. Methods: Health status, symptom, and injury information were obtained on a sample of patients presenting to the emergency department after minor injury. Postconcussion and cognitive symptoms were assessed at 1, 3, and 12 months. Results: Among 507 patients enrolled, 339 had head injury. Repeated-measures logistic regression modeling of PC and cognitive symptom presence across time indicated that baseline mental health status and physical health status were most predictive of persistent symptoms. In contrast, head injury presence did not predict persistent PC syndrome. Discussion: Baseline mental health status and physical health status were associated with persistent PC syndrome after minor injury, but head injury status was not. Further studies of PC syndrome pathogenesis are needed. © 2009 Elsevier Inc. All rights reserved. 1. Introduction 1.1. Background Patients commonly present to the emergency department (ED) for evaluation after minor head injury. Persistent ☆ This study was funded by the Centers for Disease Control (R49/ CCR523223-01). Doctor McLean is supported by NIH K23 RR017607-01. ⁎ Corresponding author. Department of Emergency Medicine and Center for Neurosensory Disorders, University of North Carolina, Chapel Hill, NC 27599-7455, USA. Tel.: +1 919 843 5931; fax: +1 919 966 3683. E-mail address: samclean@email.unc.edu (S.A. McLean). www.elsevier.com/locate/ajem 0735-6757/$ – see front matter © 2009 Elsevier Inc. All rights reserved. doi:10.1016/j.ajem.2008.01.054 American Journal of Emergency Medicine (2009) 27, 182–190