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Classification schema of posttraumatic amnesia duration-based injury severity relative to 1-year outcome : analysis of individuals with moderate and severe traumatic brain injury

Article consultable sur : http://www.archives-pmr.org

Early investigations classified traumatic brain injury (TBI) severity
according to posttraumatic amnesia (PTA) duration, designating "greater than 7
days" as the most severe.
PTA durations of more than 7 days are common in
neurorehabilitation populations. Moreover, no study has derived a PTA severity
schema anchored to late outcome. The purpose of this study was to develop a PTA
severity classification schema. DESIGN: Prospective observational study. SETTING:
Rehabilitation hospital. PARTICIPANTS: Sample included TBI Model System
participants (N=280) with known or imputed PTA duration during acute
hospitalization and 1-year productivity status. Participants were primarily male
(70%), median age of 27 years; and the most common mechanism of injury was motor
vehicle collisions (79%). For study purposes, 4 injury severity groups were
identified by observing differences in productivity associated with different PTA
durations. INTERVENTIONS: None. MAIN OUTCOME MEASURE:
Productivity status at 1 year postinjury. RESULTS: Fisher exact test comparisons revealed significant
differences among 3 of the groups. Most individuals with PTA fewer than 14 days
had favorable 1-year outcome (68% productive), whereas worse outcomes were
associated with PTA more than 28 days (18% productive). CONCLUSIONS: If validated
by other investigators, the proposed schema will be useful in determining
prognosis for late functional status based on PTA duration.

Langue : ANGLAIS

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