Loss of consciousness and altered mental state as predictors of functional recovery within 6 months following mild traumatic brain injury

Durga Roy, Matthew E. Peters, Allen D. Everett, Jeannie Marie Sheppard Leoutsakos, Haijuan Yan, Vani Rao, Kathleen T. Bechtold, Haris I. Sair, Tim Van Meter, Hayley Falk, Alexandra Vassila, Anna Hall, Uju Ofoche, Freshta Akbari, Constantine Lyketsos, Frederick Korley

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The authors tested the hypothesis that a combination of loss of consciousness (LOC) and altered mental state (AMS) predicts the highest risk of incomplete functional recovery within 6 months after mild traumatic brain injury (mTBI), compared with either condition alone, and that LOC alone is more strongly associated with incomplete recovery, compared with AMS alone. Methods: Data were analyzed from 407 patients with mTBI from Head injury Serum Markers for Assessing Response to Trauma (HeadSMART), a prospective cohort study of TBI patients presenting to two urban emergency departments. Four patient subgroups were constructed based on information documented at the time of injury: neither LOC nor AMS, LOC only, AMS only, and both. Logistic regression models assessed LOC and AMS as predictors of functional recovery at 1, 3, and 6 months. Results: A gradient of risk of incomplete functional recovery at 1, 3, and 6 months postinjury was noted, moving from neither LOC nor AMS, to LOC or AMS alone, to both. LOC was associated with incomplete functional recovery at 1 and 3 months (odds ratio=2.17, SE=0.46, p<0.001; and odds ratio=1.80, SE=0.40, p=0.008, respectively). AMS was associated with incomplete functional recovery at 1month only (odds ratio=1.77, SE=0.37 p=0.007). No association was found between AMS and functional recovery in patients with no LOC. Neither LOC nor AMS was predictive of functional recovery at later times. Conclusions: These findings highlight the need to include symptom-focused clinical variables that pertain to the injury itself when assessing who might be at highest risk of incomplete functional recovery post-mTBI.

Original languageEnglish (US)
Pages (from-to)132-138
Number of pages7
JournalJournal of Neuropsychiatry and Clinical Neurosciences
Volume32
Issue number2
DOIs
StatePublished - Apr 2020

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health

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