Cognitive Outcome 1 Year After Mild Traumatic Brain Injury: Results From the TRACK-TBI Study. (22nd March 2022)
- Record Type:
- Journal Article
- Title:
- Cognitive Outcome 1 Year After Mild Traumatic Brain Injury: Results From the TRACK-TBI Study. (22nd March 2022)
- Main Title:
- Cognitive Outcome 1 Year After Mild Traumatic Brain Injury
- Authors:
- Schneider, Andrea L.C.
Huie, J. Russell
Boscardin, W. John
Nelson, Lindsay
Barber, Jason K.
Yaffe, Kristine
Diaz-Arrastia, Ramon
Ferguson, Adam R.
Kramer, Joel
Jain, Sonia
Temkin, Nancy
Yuh, Esther
Manley, Geoffrey T.
Gardner, Raquel C. - Other Names:
- author non-byline.
Badjatia Neeraj author non-byline.
Boase Kim author non-byline.
Duhaime Ann-Christine author non-byline.
Feeser V. Ramana author non-byline.
Keene C. Dirk author non-byline.
McCrea Michael author non-byline.
Merchant Randall author non-byline.
Ngwenya Laura B. author non-byline.
Okonkwo David author non-byline.
Puccio Ava author non-byline.
Robertson Claudia author non-byline.
Schnyer David author non-byline.
Stein Murray author non-byline.
Stein Murray author non-byline.
Vasser Mary author non-byline.
Yue John K. author non-byline.
Zafonte Ross author non-byline. - Abstract:
- Abstract : Background and Objectives: The objectives of this study were to develop and establish concurrent validity of a clinically relevant definition of poor cognitive outcome 1 year after mild traumatic brain injury (mTBI), to compare baseline characteristics across cognitive outcome groups, and to determine whether poor 1-year cognitive outcome can be predicted by routinely available baseline clinical variables. Methods: Prospective cohort study included 656 participants ≥17 years of age presenting to level 1 trauma centers within 24 hours of mTBI (Glasgow Coma Scale score 13–15) and 156 demographically similar healthy controls enrolled in the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. Poor 1-year cognitive outcome was defined as cognitive impairment (below the ninth percentile of normative data on ≥2 cognitive tests), cognitive decline (change score [1-year score minus best 2-week or 6-month score] exceeding the 90% reliable change index on ≥2 cognitive tests), or both. Associations of poor 1-year cognitive outcome with 1-year neurobehavioral outcomes were performed to establish concurrent validity. Baseline characteristics were compared across cognitive outcome groups, and backward elimination logistic regression was used to build a prediction model. Results: Mean age of participants with mTBI was 40.2 years; 36.6% were female; 76.6% were White. Poor 1-year cognitive outcome was associated with worse 1-year functional outcome, moreAbstract : Background and Objectives: The objectives of this study were to develop and establish concurrent validity of a clinically relevant definition of poor cognitive outcome 1 year after mild traumatic brain injury (mTBI), to compare baseline characteristics across cognitive outcome groups, and to determine whether poor 1-year cognitive outcome can be predicted by routinely available baseline clinical variables. Methods: Prospective cohort study included 656 participants ≥17 years of age presenting to level 1 trauma centers within 24 hours of mTBI (Glasgow Coma Scale score 13–15) and 156 demographically similar healthy controls enrolled in the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. Poor 1-year cognitive outcome was defined as cognitive impairment (below the ninth percentile of normative data on ≥2 cognitive tests), cognitive decline (change score [1-year score minus best 2-week or 6-month score] exceeding the 90% reliable change index on ≥2 cognitive tests), or both. Associations of poor 1-year cognitive outcome with 1-year neurobehavioral outcomes were performed to establish concurrent validity. Baseline characteristics were compared across cognitive outcome groups, and backward elimination logistic regression was used to build a prediction model. Results: Mean age of participants with mTBI was 40.2 years; 36.6% were female; 76.6% were White. Poor 1-year cognitive outcome was associated with worse 1-year functional outcome, more neurobehavioral symptoms, greater psychological distress, and lower satisfaction with life (all p < 0.05), establishing concurrent validity. At 1 year, 13.5% of participants with mTBI had a poor cognitive outcome vs 4.5% of controls ( p = 0.003). In univariable analyses, poor 1-year cognitive outcome was associated with non-White race, lower education, lower income, lack of health insurance, hyperglycemia, preinjury depression, and greater injury severity (all p < 0.05). The final multivariable prediction model included education, health insurance, preinjury depression, hyperglycemia, and Rotterdam CT score ≥3 and achieved an area under the curve of 0.69 (95% CI 0.62–0.75) for the prediction of a poor 1-year cognitive outcome, with each variable associated with >2-fold increased odds of poor 1-year cognitive outcome. Discussion: Poor 1-year cognitive outcome is common, affecting 13.5% of patients with mTBI vs 4.5% of controls. These results highlight the need for better understanding of mechanisms underlying poor cognitive outcome after mTBI to inform interventions to optimize cognitive recovery. … (more)
- Is Part Of:
- Neurology. Volume 98:Number 12(2022)
- Journal:
- Neurology
- Issue:
- Volume 98:Number 12(2022)
- Issue Display:
- Volume 98, Issue 12 (2022)
- Year:
- 2022
- Volume:
- 98
- Issue:
- 12
- Issue Sort Value:
- 2022-0098-0012-0000
- Page Start:
- e1248
- Page End:
- e1261
- Publication Date:
- 2022-03-22
- Subjects:
- Neurology -- Periodicals
Neurology -- Periodicals
Neurologie -- Périodiques
616.8 - Journal URLs:
- http://www.mdconsult.com/public/search?search_type=journal&j_sort=pub_date&j_issn=0028-3878 ↗
http://www.mdconsult.com/about/journallist/192093418-5/about0nz0.html ↗
http://www.neurology.org ↗
http://journals.lww.com ↗ - DOI:
- 10.1212/WNL.0000000000200041 ↗
- Languages:
- English
- ISSNs:
- 0028-3878
- Deposit Type:
- Legaldeposit
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- Available online (eLD content is only available in our Reading Rooms) ↗
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- British Library DSC - 6081.500000
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