Article

OBJECTIVES: To examine long-term outcome of moderate to severe traumatic brain
injury (TBI) on timed and untimed cognitive tests using meta-analysis. DESIGN:
Meta-analysis examining outcome at 2 epochs, 6 to 18 months postinjury (epoch 1)
and 4.5 to 11 years postinjury (epoch 2). SETTING: Data source was published
articles (1966-2007) identified through electronic and manual search.
PARTICIPANTS: A total of 1380 subjects with moderate to severe TBI participated
in the 16 studies meeting inclusion criteria. INTERVENTIONS: Not applicable. MAIN
OUTCOME MEASURES: Timed and untimed neuropsychologic tests with quantitative
results (means, SDs, t, and df tests) from studies containing a healthy
comparison group and a mean time since injury falling within 1 of the 2 epochs.
RESULTS: Patient versus control weighted effect sizes were medium to large at
epoch 1 for both untimed tasks (r=-.46; confidence interval [CI], -.32 to -.65)
and timed tasks (r=-.46; CI, -.35 to -.59). At epoch 2, effect sizes were
slightly smaller for untimed tasks (r=-.38; CI, -.25 to -.60) and timed tasks
(r=-.40; CI, -.32 to -.62). CONCLUSIONS: Patients showed robust, persisting
impairments on both timed and untimed tests at recovery plateau (ie, 6-18mo
postinjury) and many years later. These findings converge with previous studies,
though using an alternative approach that obviates some of the methodologic
problems of longitudinal studies, such as selective attrition.

Langue : ANGLAIS