Multidimensional assessment of acute confusion after traumatic brain injury

Short Title:
Multidimensional assessment of acute confusion after traumatic brain injury
Model System:
TBI
Reference Type:
Journal Article
Accession No.:
J48998.
Journal:
Archives of Physical Medicine and Rehabilitation
Year, Volume, Issue, Page(s):
2005, vol. 86, issue 5, pp 896-904
Publication Website:
Abstract:
Article describes the phenomenology of posttraumatic confusional state (PTCS), as well as the development and validation of a process for assessing PTCS in patients with traumatic brain injury (TBI). The procedure, known as the Confusion Assessment Protocol (CAP), combines objective assessment of orientation and cognitive function with clinician ratings of other symptoms of confusion. The CAP measures 7 symptoms of PTCS: disorientation, cognitive impairment, fluctuation of presentation, restlessness, nighttime sleep disturbance, daytime decreased arousal, and psychotic-type symptoms. Classification of PTCS using the CAP was compared with: (1) the clinical diagnosis of delirium based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV); (2) classification of posttraumatic amnesia (PTA) based on the Galveston Orientation and Amnesia Test (GOAT); (3) and the Disability Rating score at the time of discharge from rehabilitation. Agreement between the diagnosis of PTCS with the CAP and the DSM-IV classification of delirium was 87 percent. Agreement between PTCS and PTA using the GOAT criteria was 90 percent. Patients with PTCS sustained more severe injuries and required longer rehabilitation stays. PTCS was associated with poorer functional outcome at rehabilitation discharge.
Author(s):
Sherer, Mark; Nakase-Thompson, Risa; Yablon, Stuart A.; Gontkovsky, Samuel T.
Author Address(es):
Participating Centers:

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