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Long-term cognitive prognosis of patients with severe traumatic brain injury: A prospective study
Author(s)
Date Issued
2011
Citation
Thais, M. et al. (13-15 Oct 2011). Long-term cognitive prognosis of patients with severe traumatic brain injury: A prospective study. lI Reunião Anual do IBNeC Integrando Psicologia e Neurociencia, Recife, Brazil.
Type
Conference Paper
Abstract
Traumatic brain injury (TBI) is a main cause of mortality and morbidity. Cognitive impairment after TBI is frequently studied in retrospective, including non-consecutive patients with different TBI severity and poor management of missing cases. We assessed prospectively the demographic and hospitalization variables of 234 consecutive patients with severe TBI (admission GCS ≤ 8). A representative sample
(n=46) of surviving patients (n=172) with a mean age of 34 years was evaluated cognitively on the average 3 years after TBI and compared with healthy controls (n=23) matched for age, sex and education level. Linear regression models including education and age only, or in combination with either one or two variables, showed a moderately to strong linear relationship with the cognitive performance in 14 of 15 neuropsychological tests (R coefficient = 0.6 to 0.8). Cognitive test scores were
associated with gender, admission of GCS, associated trauma and Marshal CT classification. Admission elevated glucose levels and presence of sub-arachnoids hemorrhage were independently associated with lower scores in Rey Auditory Verbal Learning retention and Logical Memory I tests respectively. Our findings indicate that education and age are important predictors of long-term cognitive disability of patients with severe TBI. Variables commonly associated with mortality including pupils’ examination, CT Marshal Classification, GCS, serum glucose trauma had a limited predictive value for cognitive performance of patients. This study demonstrates that the identification of clinical and laboratory markers of long-term cognitive disabilities is an important challenge for neuroscience applied to TBI patients. The predictive value of methodologically rigid research paradigms, however, is of high importance for the development of appropriate treatment strategies in patients with severe brain damage.
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