Toronto Rehabilitation Institute Concussion Outcome Determination and Rehab Recommendations (TRICORDRR) for Predicting Risk of Prolonged Post-Concussion Symptoms

Description

Langer et al reported the Toronto Rehabilitation Institute Concussion Outcome Determination and Rehab Recommendations (TRICORDRR) for predicting prolonged post-concussion symptoms. A patient predicted to have a high risk may benefit from more aggressive management. The authors are from the University of Toronto and affiliated institutions.

Patient selection: adult status post concussion

Parameters:

(1) bipolar disorder

(2) personality disorder

(3) anxiety and/or depression

(4) number of primary care visits in the year prior to the concussion

(5) age of the patient in years

Parameter	Finding	Points
bipolar disorder	no	0
	yes	4
personality disorder	no	0
	yes	3
anxiety and depression	no	0
	yes	1
primary care visits	<= 4	-1
	5 to 8	0
	9 to 14	1
	>= 15	3
age	18 to 30	-3
	31 to 40	-2
	41 to 50	-1
	51 to 60	0
	> 60	4

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: -4

• maximum score: 16 (need to score the psychiatric diagnoses separately to reach 16)

• The higher the score the greater the risk of prolonged post-concussion symptoms.

Total Score	Risk Prolonged Symptoms
-4	9%
-3	14%
-2	19%
-1	23%
0	28%
1	34%
2	44%
3	47%
4	54%
5	61%
6	67%
7	73%
8	78%
9	82%
10	86%
11	89%
>= 12	91%

Performance:

• The area under the ROC curve is 0.64 which is suboptimal.

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Toronto Rehabilitation Institute Concussion Outcome Determination and Rehab Recommendations (TRICORDRR) for Predicting Risk of Prolonged Post-Concussion Symptoms

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