Article

Patterns of recovery of posttraumatic
confusional state in neurorehabilitation admissions after traumatic brain injury.
OBJECTIVE: To provide preliminary descriptions of patterns of resolution of
symptoms of acute confusion after traumatic brain injury (TBI). DESIGN:
Prospective, descriptive, cohort study. SETTING: Inpatient neurorehabilitation
unit. PARTICIPANTS: Patients (N=107) meeting criteria for posttraumatic
confusional state at admission to inpatient rehabilitation. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURE: Patterns of resolution of posttraumatic
confusional state symptoms over the first 3 confusion assessment protocol
evaluations for patients with mild, moderate, and severe confusion. RESULTS:
Posttraumatic confusional state symptoms resolving earliest were psychotic-type
symptoms, decreased daytime arousal, and nighttime sleep disturbance. Fluctuation
and cognitive impairment were the 2 most persistent symptoms. Seventy-three
percent of patients showed improvement of 1 or more symptoms from the first to
third evaluation. Confusion severity groups did not significantly differ on
indices of injury severity (Glasgow Coma Scale score, time to follow commands)
but did differ on functional status at discharge from inpatient rehabilitation.
CONCLUSIONS: While posttraumatic confusional state is a heterogeneous disorder,
there is a predictable pattern of symptom resolution. Differences in patients'
confusion severity and patterns of symptoms may relate to differing underlying
neural injury.

Langue : ANGLAIS