A multicenter study on the clinical utility of post-traumatic amnesia duration in predicting global outcome after moderate-severe traumatic brain injury
Journal of Neurology Neurosurgery and Psychiatry
Year, Volume, Issue, Page(s):
2010, vol. 81, issue , pp 87-89
Background: Past research shows that post-traumatic
amnesia (PTA) duration is a particularly robust traumatic
brain injury (TBI) outcome predictor, but low specificity
limits its clinical utility.
Objectives: The current study assessed the relationship
between PTA duration and probability thresholds for
Glasgow Outcome Scale (GOS) levels.<br /><br />
Methods: Data were prospectively collected in this
multicentre observational study. The cohort was a
consecutive sample of rehabilitation patients enrolled in
the National Institute on Disability and Rehabilitation
Research funded TBI Model Systems (n=1332) that had
documented finite PTA duration greater than 24 h, and 1-
year and 2-year GOS.<br /><br />
Results: The cohort had proportionally more Good
Recovery (44% vs 39%) and less Severe Disability (19%
vs 23%) at year 2 than at year 1. Longer PTA resulted in
an incremental decline in probability of Good Recovery
and a corresponding increase in probability of Severe
Disability. When PTA ended within 4 weeks, Severe
Disability was unlikely (,15% chance) at year 1, and
Good Recovery was the most likely GOS at year 2. When
PTA lasted beyond 8 weeks, Good Recovery was highly
unlikely (,10% chance) at year 1, and Severe Disability
was equal to or more likely than Moderate Disability at
year 2<br /><br />.
Conclusions: Two PTA durations, 4 weeks and 8 weeks,
emerged as particularly salient GOS probability thresholds
that may aid prognostication after TBI.
Walker, W.C.; Ketchum, J.M.; Marwitz, J.H.; Chen, T.; Hammond, F.; Sherer, M.; Meythaler, J.
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