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The value of neurocognitive testing for acute outcomes after mild traumatic brain injury

BACKGROUND: Traditionally, neurocognitive testing is performed weeks to months after head injury and is mostly performed on patients who continue to have symptoms or difficulties. In this study, we sought to determine whether these tests, when administered acutely, could assist in predicting short-t...

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Autores principales: Ganti, Latha, Daneshvar, Yasamin, Ayala, Sarah, Bodhit, Aakash N., Peters, Keith R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957408/
https://www.ncbi.nlm.nih.gov/pubmed/27453788
http://dx.doi.org/10.1186/s40779-016-0091-4
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author Ganti, Latha
Daneshvar, Yasamin
Ayala, Sarah
Bodhit, Aakash N.
Peters, Keith R.
author_facet Ganti, Latha
Daneshvar, Yasamin
Ayala, Sarah
Bodhit, Aakash N.
Peters, Keith R.
author_sort Ganti, Latha
collection PubMed
description BACKGROUND: Traditionally, neurocognitive testing is performed weeks to months after head injury and is mostly performed on patients who continue to have symptoms or difficulties. In this study, we sought to determine whether these tests, when administered acutely, could assist in predicting short-term outcomes after acute traumatic brain injury (TBI). METHODS: This is an IRB-approved prospective study of adult patients who came to the emergency department of our Level-1 trauma center with TBI. Patients were enrolled prospectively after providing written informed consent and underwent three separate neurocognitive tests: the Galveston Orientation Amnesia Test (GOAT) the Rivermead Post-Concussion Survey Questionnaire (RPCSQ) and the Mini Mental Status Examination (MMSE). RESULTS: A lower GOAT score was significantly associated with hospitalization (P = 0.0212) and the development of post-concussion syndrome (P = 0.0081) at late follow-up. A higher RPCSQ score was significantly associated with hospital admission (P = 0.0098), re-admission within 30 days of discharge (P = 0.0431) and evidence of post-concussion syndrome (PCS) at early follow-up (P = 0.0004). A higher MMSE score was significantly associated with not being admitted to the hospital (P = 0.0002) and not returning to the emergency department (ED) within 72 hours of discharge (P = 0.0078). Lower MMSE was also significantly associated with bleeding or a fracture on the brain CT (P = 0.0431). CONCLUSIONS: While neurocognitive testing is not commonly performed in the ED in the setting of acute head injury, it is both feasible and appears to have value in predicting hospital admission and PCS. These data are especially important in terms of helping patients understand what to expect, thus, aiding in their recovery. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40779-016-0091-4) contains supplementary material, which is available to authorized users.
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spelling pubmed-49574082016-07-23 The value of neurocognitive testing for acute outcomes after mild traumatic brain injury Ganti, Latha Daneshvar, Yasamin Ayala, Sarah Bodhit, Aakash N. Peters, Keith R. Mil Med Res Research BACKGROUND: Traditionally, neurocognitive testing is performed weeks to months after head injury and is mostly performed on patients who continue to have symptoms or difficulties. In this study, we sought to determine whether these tests, when administered acutely, could assist in predicting short-term outcomes after acute traumatic brain injury (TBI). METHODS: This is an IRB-approved prospective study of adult patients who came to the emergency department of our Level-1 trauma center with TBI. Patients were enrolled prospectively after providing written informed consent and underwent three separate neurocognitive tests: the Galveston Orientation Amnesia Test (GOAT) the Rivermead Post-Concussion Survey Questionnaire (RPCSQ) and the Mini Mental Status Examination (MMSE). RESULTS: A lower GOAT score was significantly associated with hospitalization (P = 0.0212) and the development of post-concussion syndrome (P = 0.0081) at late follow-up. A higher RPCSQ score was significantly associated with hospital admission (P = 0.0098), re-admission within 30 days of discharge (P = 0.0431) and evidence of post-concussion syndrome (PCS) at early follow-up (P = 0.0004). A higher MMSE score was significantly associated with not being admitted to the hospital (P = 0.0002) and not returning to the emergency department (ED) within 72 hours of discharge (P = 0.0078). Lower MMSE was also significantly associated with bleeding or a fracture on the brain CT (P = 0.0431). CONCLUSIONS: While neurocognitive testing is not commonly performed in the ED in the setting of acute head injury, it is both feasible and appears to have value in predicting hospital admission and PCS. These data are especially important in terms of helping patients understand what to expect, thus, aiding in their recovery. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40779-016-0091-4) contains supplementary material, which is available to authorized users. BioMed Central 2016-07-22 /pmc/articles/PMC4957408/ /pubmed/27453788 http://dx.doi.org/10.1186/s40779-016-0091-4 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Ganti, Latha
Daneshvar, Yasamin
Ayala, Sarah
Bodhit, Aakash N.
Peters, Keith R.
The value of neurocognitive testing for acute outcomes after mild traumatic brain injury
title The value of neurocognitive testing for acute outcomes after mild traumatic brain injury
title_full The value of neurocognitive testing for acute outcomes after mild traumatic brain injury
title_fullStr The value of neurocognitive testing for acute outcomes after mild traumatic brain injury
title_full_unstemmed The value of neurocognitive testing for acute outcomes after mild traumatic brain injury
title_short The value of neurocognitive testing for acute outcomes after mild traumatic brain injury
title_sort value of neurocognitive testing for acute outcomes after mild traumatic brain injury
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957408/
https://www.ncbi.nlm.nih.gov/pubmed/27453788
http://dx.doi.org/10.1186/s40779-016-0091-4
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