Limited predictive power of hospitalization variables for long‐term cognitive prognosis in adult patients with severe traumatic brain injury

Thais, Maria Emília Rodrigues de Oliveira; Cavallazzi, G; Formolo, Douglas Affonso; Castro, Lucas D'Ávila de; Schmoeller, Roseli; Guarnieri, Ricardo; Schwarzbold, Marcelo Libório; Diaz, Alexandre Paim; Hohl, Alexandre; Prediger, Rui Daniel; Mäder, Maria Joana; Linhares, Marcelo Neves; Staniloiu, Angelica; Markowitsch, Hans J.; Walz, Roger

doi:10.1111/jnp.12000

Cited by 22 publications

(33 citation statements)

References 58 publications

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“…13 There are several studies that have examined which factors may influence cognitive impairment after TBI. Consistently, older individuals seem to fare more poorly than younger individuals in all stages of recovery from acute care, 18 during the first years after TBI, 19,20 and between 5 to 22 years after injury. 21 Lower education has been modestly associated with poorer cognitive outcome, 18,19,22 and with slower rate of recovery 22 in the TBI literature.…”

Section: Textmentioning

confidence: 85%

Neuropsychological Functioning in a National Cohort of Severe Traumatic Brain Injury

Sigurðardóttir

Anđelić

Wehling

et al. 2015

Journal of Head Trauma Rehabilitation

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Section: Textmentioning

confidence: 85%

Neuropsychological Functioning in a National Cohort of Severe Traumatic Brain Injury

Sigurðardóttir

Anđelić

Wehling

et al. 2015

Journal of Head Trauma Rehabilitation

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“…Indeed, preinjury factors, such as education level and age, influence recovery after TBI. 13,24,33,34,41 Pediatric TBI patients may have prolonged impairment, demonstrated by poor school performance, poor quality of life measures, need for special education services, and mental health problems.…”

Section: Predictive Variables For Clinical Outcomementioning

confidence: 99%

Analysis of long-term (median 10.5 years) outcomes in children presenting with traumatic brain injury and an initial Glasgow Coma Scale score of 3 or 4

Fulkerson

White

Rees

et al. 2015

PED

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OBJECT Patients with traumatic brain injury (TBI) with low presenting Glasgow Coma Scale (GCS) scores have very high morbidity and mortality rates. Neurosurgeons may be faced with difficult decisions in managing the most severely injured (GCS scores of 3 or 4) patients. The situation may be considered hopeless, with little chance of a functional recovery. Long-term data are limited regarding the clinical outcome of children with severe head injury. The authors evaluate predictor variables and the clinical outcomes at discharge, 1 year, and long term (median 10.5 years) in a cohort of children with TBI presenting with postresuscitation GCS scores of 3 and 4. METHODS A review of a prospectively collected trauma database was performed. Patients treated at Riley Hospital for Children (Indianapolis, Indiana) from 1988 to 2004 were reviewed. All children with initial GCS (modified for pediatric patients) scores of 3 or 4 were identified. Patients with a GCS score of 3 were compared with those with a GCS score of 4. The outcomes of all patients at the time of death or discharge and at 1-year and long-term follow-up were measured with a modified Glasgow Outcome Scale (GOS) that included a “normal” outcome. Long-term outcomes were evaluated by contacting surviving patients. Statistical "classification trees" were formed for survival and outcome, based on predictor variables. RESULTS Sixty-seven patients with a GCS score of 3 or 4 were identified in a database of 1636 patients (4.1%). Three of the presenting factors differed between the GCS 3 patients (n = 44) and the GCS 4 patients (n = 23): presence of hypoxia, single seizure, and open basilar cisterns on CT scan. The clinical outcomes were statistically similar between the 2 groups. In total, 48 (71.6%) of 67 patients died, remained vegetative, or were severely disabled by 1 year. Eight patients (11.9%) were normal at 1 year. Ten of the 22 patients with long-term follow-up were either normal or had a GOS score of 5. Multiple clinical, historical, and radiological factors were analyzed for correlation with survival and clinical outcome. Classification trees were formed to stratify predictive factors. The pupillary response was the factor most predictive of both survival and outcome. Other factors that either positively or negatively correlated with survival included hypothermia, mechanism of injury (abuse), hypotension, major concurrent symptoms, and midline shift on CT scan. Other factors that either positively or negatively predicted long-term outcome included hypothermia, mechanism of injury, and the assessment of the fontanelle. CONCLUSIONS In this cohort of 67 TBI patients with a presenting GCS score of 3 or 4, 56.6% died within 1 year. However, approximately 15% of patients had a good outcome at 10 or more years. Factors that correlated with survival and outcome included the pupillary response, hypothermia, and mechanism. The authors discuss factors that may help surgeons make critical decisions regarding their most serious pediatric trauma patients.

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“…In accordance with previously published guidelines 15,16 , the process of cross-cultural adaptation of the SCATBI included the following five steps: [1] translation; [2] back-translation; [3] review by an expert committee to ensure semantic, idiomatic, experiential and conceptual equivalence; [4] testing of the pre-final version; and [5] analysis of the scores.…”

Section: Study Design and Settingsmentioning

confidence: 99%

“…The TBI may result in multiple cognitive deficits. The most commonly found sequelae are deficits in attention and memory, difficulty in learning new information, resolving problems, planning; as well as disturbances associated with impulsivity, self-control 9,10 and personality changes 3,5,6 . Currently, a limited number of test batteries has been developed to assess the presence and severity of cognitive-communicative deficits associated with TBI.…”

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confidence: 99%

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Cross-cultural adaptation of the SCATBI instrument for cognitive-linguistic abilities after traumatic brain injury

Janzen

Walz

Lin

2015

Arq. Neuro-Psiquiatr.

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Objective To perform the cross-cultural adaptation of the “Scales of Cognitive Ability for Traumatic Brain Injury” (SCATBI).Method After the translation and back-translation phases, a multidisciplinary committee judged and elaborated versions in order to maintain its conceptual equivalence, content, comprehensibility and contextual adjustment for Brazilian population. The final version was tested on 55 healthy subjects.Results The individuals’ mean age was 41.75 ± 17.40 years (range = 18-81), 69% were women and they had a mean schooling of 12.96 ± 4.55 years. Higher total scores were positively correlated with years of schooling (p < 0.001) and social-economic status (p = 0.001), while older aged individuals performed worse than younger ones (p = 0.001). Both genders performed similarly on all domains of the instrument, except for “organization” ability, where women performed significantly better than men (p = 0.02).Conclusion The Brazilian version of SCATBI is a useful tool for the diagnosis and monitoring of cognitive impairments after a traumatic brain injury.

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Limited predictive power of hospitalization variables for long‐term cognitive prognosis in adult patients with severe traumatic brain injury

Cited by 22 publications

References 58 publications

Neuropsychological Functioning in a National Cohort of Severe Traumatic Brain Injury

Neuropsychological Functioning in a National Cohort of Severe Traumatic Brain Injury

Analysis of long-term (median 10.5 years) outcomes in children presenting with traumatic brain injury and an initial Glasgow Coma Scale score of 3 or 4

Cross-cultural adaptation of the SCATBI instrument for cognitive-linguistic abilities after traumatic brain injury

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