Michael McCrea1, Kevin Guskiewicz2, Selina Doncevic3, Katherine Helmick1, Jan Kennedy4, Cynthia Boyd4, Sarah Asmussen4, Kwang W Ahn5, Yanzhi Wang5, James Hoelzle6, Michael Jaffee7. 1. Departments of Neurosurgery and Neurology, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI 53226. 2. Injury Prevention Research Center, University of North Carolina at Chapel Hill, 209 Fetzer Hall Box 8700, Chapel Hill, NC 27599. 3. Department of Veterans Affairs, Washington, DC, 8901 Rockville Pike, Bethesda, MD 20889. 4. Defense and Veterans Brain Injury Center, 1335 East-West Highway, Suite 6-100, Silver Spring, MD 20910. 5. Division of Biostatistics, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI 53226. 6. Department of Psychology, Marquette University, 1250 W Wisconsin Avenue, Milwaukee, WI 53233. 7. Department of Neurology, University of Virginia, PO Box 800394, Charlottesville, VA 22908.
Abstract
OBJECTIVES: The study investigated the clinical validity of the cognitive screening component of the Military Acute Concussion Evaluation (MACE) for the evaluation of acute mild traumatic brain injury (mTBI) in a military operational setting. METHODS: This was a retrospective data study involving analysis of MACE data on Operation Enduring Freedom/Operation Iraqi Freedom deployed service members with mTBI. In total, 179 cases were included in analyses based on ICD-9 diagnostic codes and characteristics of mTBI, and availability of MACE data on day of injury. MACE data from the mTBI group was compared to a military sample without mTBI administered the MACE as part of a normative data project. RESULTS: On day of injury, the mTBI group performed worse than controls on the MACE cognitive test (d = 0.90), with significant impairments in all cognitive domains assessed. MACE cognitive score was strongly associated with established indicators of acute injury severity. Lower MACE cognitive performance on day of injury was predictive of lengthier postinjury recovery time and time until return to duty after mTBI. CONCLUSIONS: Findings from the current study support the use of the MACE as a valid screening tool to assess for cognitive dysfunction in military service members during the acute phase after mTBI. Reprint &
OBJECTIVES: The study investigated the clinical validity of the cognitive screening component of the Military Acute Concussion Evaluation (MACE) for the evaluation of acute mild traumatic brain injury (mTBI) in a military operational setting. METHODS: This was a retrospective data study involving analysis of MACE data on Operation Enduring Freedom/Operation Iraqi Freedom deployed service members with mTBI. In total, 179 cases were included in analyses based on ICD-9 diagnostic codes and characteristics of mTBI, and availability of MACE data on day of injury. MACE data from the mTBI group was compared to a military sample without mTBI administered the MACE as part of a normative data project. RESULTS: On day of injury, the mTBI group performed worse than controls on the MACE cognitive test (d = 0.90), with significant impairments in all cognitive domains assessed. MACE cognitive score was strongly associated with established indicators of acute injury severity. Lower MACE cognitive performance on day of injury was predictive of lengthier postinjury recovery time and time until return to duty after mTBI. CONCLUSIONS: Findings from the current study support the use of the MACE as a valid screening tool to assess for cognitive dysfunction in military service members during the acute phase after mTBI. Reprint &
Authors: Monty T Baker; John C Moring; Willie J Hale; Jim Mintz; Stacey Young-McCaughan; Richard A Bryant; Donna K Broshek; Jeffrey T Barth; Robert Villarreal; Cynthia L Lancaster; Steffany L Malach; Jose M Lara-Ruiz; William Isler; Alan L Peterson Journal: Mil Med Date: 2018-11-01 Impact factor: 1.437