Cognitive dysfunction is a significant complaint among patients after moderate to severe traumatic brain injury (TBI), with devastating consequences on functional recovery and quality of life. Prognostic models allow a better assessment and management of neurotrauma patients. The aim of the study was to demonstrate the predictive value of the Baseline Prognostic Risk Score (BPRS) in moderate to severe TBI, in a sample of patients treated with neurotrophic factors. Eighty patients with moderate-severe TBI from the CAPTAIN II study were included in secondary data analysis. Patients received active treatment with Cerebrolysin, 50 mL per day for ten days, followed by two treatment cycles with 10 mL per day for ten days. BPRS was determined on admission; the age was recorded, and patients were evaluated using the following neurocognitive tests: Mini-Mental State Essay (MMSE), Wechsler Adult Intelligence Scale-Third Edition Processing Speed Index (WAIS-III PSI) and Stroop Colour Word Test-Victoria Version at 10, 30 and 90 days. Hierarchical regression analysis was performed to investigate the unique predictive value of BPRS on cognitive evolution, independent of age. BPRS independently predicted scores on the WAIS-III PSI DSCales and the Word subscale of the Stroop Colour Word Test at 90 days. Age was a significant predictor for all the investigated scales at 10, 30, and 90 days. This study demonstrates the predictive value of a validated prognostic model (BPRS) for medium-term neurocognitive outcomes in a sample of moderate-severe traumatic brain injury treated with neurotrophic factors.
Keywords: AIS - Abbreviated Injury Scale; BPRS - Baseline Prognostic Risk Score; CTT - Colour Trails Test; Cerebrolysin; GCS - Glasgow Coma Scale; GOSE - Glasgow Outcome Scale Extended; HADS - Hospital Anxiety and Depression Scale; IMPACT - The International Mission on Prognosis and Analysis of Clinical Trials in TBI; MMSE - Mini Mental State Examination; MRC CRASH - Medical Research Council Corticosteroid Randomization after Significant Head Injury; PSI DSC - Processing Speed Index Digit Symbol Coding; PSI SS - Processing Speed Index Symbol Search; PTA - post-traumatic amnesia; TBI - Traumatic Brain Injury; Traumatic brain injury; WAIS III - Wechsler Adult Intelligence Scale Third Edition.; cognitive outcome; prognostic.
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