Cognitive Performance of Brazilian Patients With Favorable Outcomes After Severe Traumatic Brain Injury: A Prospective Study.

Helena Dresch Vascouto Hiago Murilo Melo Maria Emília Rodrigues de Oliveira Thais Marcelo Libório Schwarzbold Katia Lin Felipe Dal Pizzol Emil Kupek Roger Walz

Am J Phys Med Rehabil

From the Center for Applied Neuroscience (CeNAp), Department of Clinical Medicine, University Hospital-UFSC (HU-UFSC) (HDV, HMM, MLS, KL, RW), Graduate Program in Neuroscience (HDV, HMM, MERdOT, RW), Graduate Program in Medical Sciences (MERdOT, MLS, KL, RW), Psychiatry Unit, Department of Internal Medicine, University Hospital (HU) (MLS), Neurology Unit, Department of Internal Medicine, University Hospital-UFSC (HU-UFSC) (KL, RW), and Department of Public Health (EK), Federal University of Santa Catarina (UFSC), Florianópolis/SC; and Laboratory of Neurobiology of Inflammatory and Metabolic Processes, Graduate Program in Health Sciences, Health Sciences Unit, University of South Santa Catarina, Santa Catarina, Brazil (FDP).

Published: December 2023

The study aimed to assess cognitive performance one year after hospital discharge in patients with severe traumatic brain injury who had favorable outcomes.
Out of 163 patients, 73 showed favorable outcomes based on the Glasgow Outcome Scale, but only 28 completed cognitive evaluations, which were then compared to healthy controls.
Results indicated that many patients experienced significant cognitive deficits, especially in language and verbal memory, despite being categorized with favorable outcomes, with factors like longer hospital stays, older age, and lower education correlating with poorer performance.

Objective: The aim of this study was to investigate the cognitive performance of patients with favorable outcomes, determined by the Glasgow Outcome Scale, 1 yr after hospital discharge due to severe traumatic brain injury.

Design: This was a prospective case-control study. From 163 consecutive adult patients with severe traumatic brain injury included in the study, 73 patients had a favorable outcome (Glasgow Outcome Scale score of 4 or 5) 1 yr after hospital discharge and were eligible for the cognitive evaluation, of which 28 completed the evaluations. The latter were compared with 44 healthy controls.

Results: The average loss of cognitive performance among participants with traumatic brain injury varied between 13.35% and 43.49% compared with the control group. Between 21.4% and 32% of the patients performed below the 10th percentile on three language tests and two verbal memory tests, whereas 39% to 50% performed below this threshold on one language test and three memory tests. Longer hospital stay, older age, and lower education were the most important predictors of worse cognitive performance.

Conclusion: One year after a severe traumatic brain injury, a significant proportion of Brazilian patients with the favorable outcome determined by Glasgow Outcome Scale still showed significant cognitive impairment in verbal memory and language domains.

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http://dx.doi.org/10.1097/PHM.0000000000002279	DOI Listing

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