A prospective study on the role of variables of the acute phase of trauma in the long-term cognitive outcome of severe traumatic brain injury

Patients who survive severe traumatic brain injury (TBI) frequently present persistent cognitive deficits, but little is known about the role of variables of the acute phase of TBI in these sequelae. Here we prospectively assessed 46 consecutive severe TBI survivors by age, gender, education, Glasgow Coma Scale, pupillary response, blood glucose, associated trauma, subarachnoid hemorrhage, and Marshall computed tomography (CT) score. After a period of 2.5 ± 1.5 years patients were compared to controls in a test battery including the Letters and Category Fluency tests, Trail Making Test (TMT), Rey Auditory Verbal Learning Test (RAVLT), Wechsler Memory Scale III (WMS-III), and Wechsler Adult Intelligence Scale III (WAIS-III). A multivariate analysis was conducted to determine independent associations between cognitive tests performance and hospitalization and demographic variables. Although severe TBI survivors scored lower than controls in all tests, only the TMT, age and education were independently associated with these deficits. WMS-III visual reproduction was affected by the Marshall CT score and pupillary status. Marshall CT score was also associated with RAVLT impairment, and subarachnoid hemorrhage with the WMS-III logical memory. Education, age and variables of the acute phase of severe TBI are associated with cognitive outcome after the severe TBI.

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A prospective study on the role of variables of the acute phase of trauma in the long-term cognitive outcome of severe traumatic brain injury

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