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

Military Medical research 2015年第3期3卷 123-132页

作者： Latha Ganti Yasamin Daneshvar Sarah Ayala Pratik Shashikant Patel Aakash N.Bodhit keith r.peters Orlando Veterans Affairs Medical Center

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.

关键词： Neurocognitive testing Mild traumatic brain injury Treatment outcome

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Effectiveness of seatbelts in mitigating traumatic brain injury severity

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World Journal of Emergency Medicine 2021年第1期12卷 68-72页

作者： Latha Ganti Aakash NBodhit Yasamin Daneshvar Kelsey Hatchitt Sudeep Kuchibhotla Christa Pulvino Sarah WAyala keith rpeters Emergency Medicine and Neurology University of Central Florida College of MedicineOrlando 32827USA Department of Neurology Saint Louis UniversitySaint Louis 63103USA New York College of Podiatric Medicine New York 10035USA George Washington University Washington DC 20052USA Texas Heart Institute Houston 77030USA Department of Emergency Medicine University of CincinnatiCincinnati 45221USA Touro College of Osteopathic Medicine Vallejo 94592USA Department of radiology University of FloridaGainesville 32610USA

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]

关键词： admitted injuries traumatic

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