INTRODUCTION Over the past few decades,traumatic brain injuries(TBIs)have become one of the leading causes of death and the leading cause of injury-related death in the USA.[1,2]It is estimated that 1.70 million peopl...INTRODUCTION Over the past few decades,traumatic brain injuries(TBIs)have become one of the leading causes of death and the leading cause of injury-related death in the USA.[1,2]It is estimated that 1.70 million people are subject to TBIs each year.[2]Males are more likely to sustain TBIs(59%);the most common age groups are 0–5 years,15–19 years,and>65 years.[2]Approximately 1.36 million people present to the emergency department(ED),275,000 are admitted to the hospital,and 52,000 people die from TBIs.[2]The leading causes of TBIs are falling(35.2%),motor vehicle collisions(MVCs,17.3%),struck by/against an object(16.5%),and assault(10.0%).[2]These statistics combine to make TBIs the leading cause of injury-related death in the USA at 30.5%.[2]It has been estimated that,with specifi c guidelines from the Brain Trauma Foundation,up to 50.0%of the 52,000 TBIrelated deaths may be prevented.[3]展开更多
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...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 PostConcussion 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(PCS) at late follow-up(P=0.0081). 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 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.展开更多
文摘INTRODUCTION Over the past few decades,traumatic brain injuries(TBIs)have become one of the leading causes of death and the leading cause of injury-related death in the USA.[1,2]It is estimated that 1.70 million people are subject to TBIs each year.[2]Males are more likely to sustain TBIs(59%);the most common age groups are 0–5 years,15–19 years,and>65 years.[2]Approximately 1.36 million people present to the emergency department(ED),275,000 are admitted to the hospital,and 52,000 people die from TBIs.[2]The leading causes of TBIs are falling(35.2%),motor vehicle collisions(MVCs,17.3%),struck by/against an object(16.5%),and assault(10.0%).[2]These statistics combine to make TBIs the leading cause of injury-related death in the USA at 30.5%.[2]It has been estimated that,with specifi c guidelines from the Brain Trauma Foundation,up to 50.0%of the 52,000 TBIrelated deaths may be prevented.[3]
基金supported by an endowment from The Toral Family Foundation, 13131 SW 19th Street, Davie, Florida 33325, USA (toralfamilyfoundation.org)
文摘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 PostConcussion 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(PCS) at late follow-up(P=0.0081). 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 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.
