E de Guise1,2,3, J LeBlanc4, M Feyz4, J Lamoureux5, S Greffou4,6. 1. a Department of Psychology , University of Montreal , Montreal , QC , Canada. 2. b Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR) , Montreal , QC , Canada. 3. c Research Institute-McGill University Health Centre , Montreal , QC , Canada. 4. d Traumatic Brain Injury Program, McGill University Health Centre , Montreal , QC , Canada. 5. e Social and Preventive Medicine Department , University of Montreal , Montreal , QC , Canada. 6. f Neurology and neurosurgery Department , McGill University , Montreal , QC , Canada.
Abstract
OBJECTIVE: The goal of this study was to identify factors that would predict short-term neuropsychological outcome in patients with traumatic brain injury (TBI) hospitalized in an acute rehabilitation setting. METHODS: Data was collected in the context of an acute early rehabilitation setting of a trauma centre. A brief neuropsychological assessment was carried out for 348 patients within a month following their trauma. RESULTS: Length of post-traumatic amnesia (PTA) was the best predictor of behavioural, memory and executive function variables within a month post TBI. The odds of being agitated, labile, irritable and disinhibited at one month post trauma were almost six times higher for those with PTA that lasted more than 7 days compared to those with a PTA of less than 24 hours. Also, the odds of having a higher mental manipulation score (less significant executive function impairment) were almost two times lower for those with frontal lesions, and three to six times lower for those with PTA of more than 24 hours. In addition, TBI severity, education and age were considered good predictors of some aspects of neuropsychological outcome. CONCLUSION: This model may help clinicians and administrators recognize the probable post-traumatic deficits as quickly as possible and to plan interventions as well as post-acute discharge orientation accordingly and early on.
OBJECTIVE: The goal of this study was to identify factors that would predict short-term neuropsychological outcome in patients with traumatic brain injury (TBI) hospitalized in an acute rehabilitation setting. METHODS: Data was collected in the context of an acute early rehabilitation setting of a trauma centre. A brief neuropsychological assessment was carried out for 348 patients within a month following their trauma. RESULTS: Length of post-traumatic amnesia (PTA) was the best predictor of behavioural, memory and executive function variables within a month post TBI. The odds of being agitated, labile, irritable and disinhibited at one month post trauma were almost six times higher for those with PTA that lasted more than 7 days compared to those with a PTA of less than 24 hours. Also, the odds of having a higher mental manipulation score (less significant executive function impairment) were almost two times lower for those with frontal lesions, and three to six times lower for those with PTA of more than 24 hours. In addition, TBI severity, education and age were considered good predictors of some aspects of neuropsychological outcome. CONCLUSION: This model may help clinicians and administrators recognize the probable post-traumatic deficits as quickly as possible and to plan interventions as well as post-acute discharge orientation accordingly and early on.
Authors: Marlies L Timmer; Bram Jacobs; Marleen C Schonherr; Jacoba M Spikman; Joukje van der Naalt Journal: Front Neurol Date: 2020-04-07 Impact factor: 4.003