Cognitive-communication skills and acute outcome following mild traumatic brain injury.

Purpose: Little is known about cognitive-communication skills post mild traumatic brain injury (mTBI). We aimed to determine how performance on cognitive-communication measures in the acute recovery period relates to early outcome following complicated mTBI.

Method: Results of language and communication skill measures, demographic and accident-related data, length of stay (LOS), Glasgow Outcome Scale-Extended (GOSE) scores and discharge destinations were retrospectively gathered for 128 admitted patients with complicated mTBI.

Results: More than half of the individuals required rehabilitation services post discharge from hospital with over a third needing in-patient rehabilitation. Patients with poorer skills in auditory comprehension, verbal reasoning, confrontation naming, verbal fluency and conversational discourse were more likely to require in-patient rehabilitation. Subjects with worse skills in naming, conversational discourse and letter-category verbal fluency had a greater chance of being referred to out-patient rehabilitation services. Thus patients with both auditory comprehension and oral expression deficits were more likely to require in-patient services whereas those who had oral expression deficits but no significant difficulty in auditory comprehension were more often referred to out-patient services. Also, worse conversational discourse skills and semantic-category naming ability were related to lower GOSE scores and the chance of a longer LOS was greater when letter-category naming was poorer.

Conclusion: The likelihood of individuals requiring rehabilitation services post mTBI was related to performance on several oral expression and auditory comprehension measures. It is therefore important to evaluate cognitive-communication skills early to determine rehabilitation needs.