Hyperbaric oxygen for persistent post-concussive symptoms: long-term follow-up.

Abstract

We report results of an observational cohort study investigating long-term follow-up in participants from two completed United States military trials of hyperbaric oxygen (HBO₂) for persistent post-concussive symptoms (PCS), as well as challenges in recruitment and retention in active-duty military personnel. After informed consent, participants completed an electronic survey assessing PCS, post-traumatic stress disorder (PTSD), anxiety, depression and quality of life. Of 132 HBO₂ study participants, 40 (30%) completed the survey (42 could not be contacted; 50 were lost to follow-up or declined). All were male, age 28.1 ±6.6 years (mean ±1SD). Time to follow-up was 39.2 ±6.1 months. At follow-up, participants reported continued symptoms of PTSD, depression, anxiety and reduced quality of life. Among DARPA/VCU study participants, total PCS scores worsened in the 1.5 atmospheres absolute (ATA) equivalent HBO₂ group (mean change 7.4 ±15.8) and improved in the sham (-8.0 ±7.7) and 2.0 atmospheres absolute equivalent HBO₂ groups (-3.3 ±7.4). Individual changes varied widely, range -23 to +28 points. In participants from the HOPPS study, total PCS scores worsened in all groups: local care (10.5 ±8.7), sham (7.9 ±11.9) and 1.5 ATA HBO₂ (1.0 ±19.4). In this limited, cross-sectional sample, PCS and PTSD symptoms did not appear to improve over time by descriptive analyses. Low participation rates and potential response bias limit our ability to perform statistical hypothesis testing and to draw conclusions from these data. Future studies should prospectively plan longitudinal follow-up and regular engagement with participants to minimize attrition.

• Authors: Leonard D Skipper, Susan Churchill, Steffanie H Wilson, Kayla Deru, Robert J Labutta, Brett B Hart
• Journal: Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc (Undersea Hyperb Med) 2016 Aug-Sept Vol. 43 Issue 5 Pg. 601-613 ISSN: 1066-2936 [Print] United States
• PMID: 28768076 (Publication Type: Journal Article, Observational Study, Randomized Controlled Trial)
• Copyright: Copyright© Undersea and Hyperbaric Medical Society.

Chemical References

• Central Nervous System Agents

Topics

• Adult
• Atmospheric Pressure
• Brain Concussion (complications)
• Central Nervous System Agents (therapeutic use)
• Cross-Sectional Studies
• Follow-Up Studies
• Humans
• Hyperbaric Oxygenation
• Male
• Middle Aged
• Military Personnel
• Patient Dropouts (statistics & numerical data)
• Patient Selection
• Post-Concussion Syndrome (etiology, therapy)
• Quality of Life
• Treatment Outcome
• United States