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Citation
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Potvin MJ, Brayet P, Paradis V, Overbeek C, Therrien, Dion LA, Bernard F, Gosselin N, Rouleau I, Boucher O, Giguère JF. Arch. Phys. Med. Rehabil. 2022; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: To determine how results on the EXACT (EXAmen Cognitif abrégé en Traumatologie), a new test specifically designed to briefly assess global cognitive functioning during the acute phase of traumatic brain injury (TBI), can predict long-term functional outcome compared to length of post-traumatic amnesia (PTA), a well-established predictor.
DESIGN: Inception cohort. SETTINGS: Level 1 trauma center. PARTICIPANTS: A total of 90 patients hospitalized for a moderate or severe TBI. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: Performance on the EXACT in the first three months after injury and results on the Disability Rating Scale (DRS) at follow-up one to two years later.
RESULTS: EXACT scores were all correlated with length of PTA and DRS result. Compared to length of PTA, the EXACT added significantly to the regression and improved prediction of functional outcome. More specifically, a total score of ≤ 80 on the EXACT was associated with a higher rate of long-term disability due to more severe TBI consequences. Behavioral regulation and executive functions were the cognitive domain that showed the most impairment, followed by attention and working memory, and episodic memory. Except for length of PTA and hospital stay, the DRS score was not correlated with other demographic (age, education) or clinical variables (Glasgow Coma Scale and maximum score on the Therapy Intensity Level Scale).
CONCLUSION: The EXACT can be administered to most patients early in the acute phase of TBI and results could be used, along with other predictors like PTA, to estimate their long-term functional sequelae. The EXACT may be a promising brief cognitive instrument for future studies investigating recovery after TBI.
Language: en |