Measures of injury severity and prediction of acute traumatic brain injury outcomes

J Head Trauma Rehabil. 2015 Mar-Apr;30(2):136-42. doi: 10.1097/HTR.0000000000000026.

Abstract

Objective: To examine the comparative efficacy of 3 common measures of traumatic brain injury (TBI) severity for predicting inpatient outcomes upon hospital discharge.

Setting: Acute brain injury rehabilitation unit at level 1 trauma center.

Participants: 100 patients with TBI.

Design: Retrospective analysis of injury severity, demographic, and outcome data.

Main measures: Glasgow Coma Scale (GCS) at admission, time to follow commands (TTC), duration of posttraumatic amnesia (PTA), and Functional Independence Measure at hospital discharge.

Results: A hierarchal multiple regression revealed that duration of PTA was a significant and powerful unique predictor of Functional Independence Measure scores at discharge (β = -0.46, P = .001), while TTC (β = 0.26, P = .056) and GCS (β = 0.16, P = .143) were not. These effects were present even after controlling for age, gender, educational level, racial/ethnic minority status, cause of injury, history of substance abuse, and neurosurgical intervention.

Conclusion: Although clinicians often use GCS scores and TTC when assessing acute TBI severity and during treatment formulation, this study provides evidence that duration of PTA may be a more meaningful predictor of patients' functional levels at discharge.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Brain Injuries / complications
  • Brain Injuries / psychology
  • Brain Injuries / rehabilitation*
  • Female
  • Glasgow Coma Scale
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Recovery of Function
  • Retrospective Studies
  • Socioeconomic Factors
  • Treatment Outcome
  • Young Adult