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Abstract
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OBJECTIVE: To examine the utility of the Abbreviated Westmead Post-traumatic Amnesia Scale (A-WPTAS), which includes the Glasgow Coma Scale (GCS) and three picture cards used to measure amnesia, in identifying the presence or absence of post-traumatic amnesia (PTA) in individuals with mild traumatic brain injury (mTBI).
DESIGN: A prospective study utilizing data from the A-WPTAS. SETTING: An ED of a Level 1 trauma hospital. PARTICIPANTS: Individuals, aged between 18 to 65 years, with possible mTBI who presented between April and September, 2011 (N=252; mean age, 37.4±13.9y; 77% men). INTERVENTIONS: Administration of the A-WPTAS. MAIN OUTCOME MEASURES: GCS, A-WPTAS pass/fail rates.
RESULTS: One hundred and sixty-nine individuals (mean age, 35.1±13.6y; 77% men) received the scale. A pass/fail performance was achieved a median 121 minutes (interquartile range, 89=205 minutes) following triage. Of the 45 who failed, 31 (69%) had a GCS of 15. The likelihood of failing was associated with being older (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.06; P<.05) having consumed alcohol (OR, 3.09; 95% CI, 1.42-6.74, P<.01), and the scale being administered closer to the time of the injury (OR, 0.99; 95% CI, 0.99-1.00; P<.05). Nineteen (42%) of those who failed had consumed alcohol; 11 had a GCS of 15, and 8 a GCS of 14.
CONCLUSIONS: A GCS of 15 does not always signify return to normal cognitive function. Individuals with a GCS of 15 who are acutely cognitively impaired are at risk of not being accurately identified. The addition of an amnesia score to the GCS in the A-WPTAS will assist in making a diagnosis of mTBI.
Language: en |