Post-Concussion Symptoms Rule (PoCS Rule) of Le Sage et al: Initial Assessment

Description

Le Sage et al reported a Post-Concussion Symptoms Rule for evaluating a patient after a traumatic brain injury (TBI). This consists of an initial assessment, with a follow-up assessment as needed. The authors are from multiple institutions in Canada and Australia.

Patient selection: mild traumatic brain injury, >= 14 years

Outcome: persistent symptoms

Initial assessment:

(1) age in years

(2) sex

(3) history of prior multiple traumatic brain injuries (TBI)

(4) history of prior brain injury within the past year

(5) history of mental health disorder

(6) headache at time of assessment

(7) cervical sprain

(8) hemorrhage on brain CT

Parameter	Finding	Points
age of the patient	< 25 years	0
	25 to 34 years	1
	35 to 44 years	3
	45 to 64 years	2
	>= 65 years	0
sex	male	0
	female	1
multiple TBI	no	0
	yes	1
TBI in past year	no	0
	yes	2
mental health disorder	no	0
	yes	1
headache at exam	no	0
	yes	1
cervical sprain	no	0
	yes	2
hemorrhage on CT	no	0
	yes	2

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: 0

• maximum score: 13

Total Score	Risk Category	Management
0 or 1	low	consult PRN
2 to 6	medium	observe with follow-up exam
7 to 13	high	evaluate and/or intervene

Performance:

• The negative predictive value was 0.97.

• The sensitivity is good (around 0.90 but specificity is 0.45 to 0.54.

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Post-Concussion Symptoms Rule (PoCS Rule) of Le Sage et al: Initial Assessment

Description

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