Produção Nacional
Revisado por pares
Limited predictive power of hospitalization variables for long‐term cognitive prognosis in adult patients with severe traumatic brain injury
2012; Wiley; Volume: 8; Issue: 1 Linguagem: Inglês
10.1111/jnp.12000
ISSN1748-6653
AutoresMaria Emília Rodrigues de Oliveira Thais, G Cavallazzi, Douglas Affonso Formolo, Lucas D'Ávila de Castro, Roseli Schmoeller, Ricardo Guarnieri, Marcelo Libório Schwarzbold, Alexandre Paim Díaz, Alexandre Hohl, Rui Daniel Prediger, Maria Joana Mäder, Marcelo Neves Linhares, Angelica Staniloiu, Hans J. Markowitsch, Roger Walz,
Tópico(s)Cardiac Arrest and Resuscitation
ResumoObjectives Traumatic brain injury ( TBI ) is a main cause of mortality and morbidity. Association studies between hospitalization variables and cognitive impairment after TBI are frequently retrospective, including non‐consecutive patients showing variable degrees of TBI severity, and poor management of missing (drop out) cases. Methods We assessed prospectively the demographic and hospitalization variables of 234 consecutive patients with severe TBI (admission G lasgow C oma S cale [ GCS ] ≤8) and determined their independent association with cognitive performance in a representative sample ( n = 46) of surviving patients ( n = 172) evaluated 3 (±1.8) years after hospitalization. Results In all, 85% of patients were male and the mean age was 34 ( SD ±13) years. The education level was 9 (±4.7) years. As expected, education and age showed a moderately to strong linear relationship with the cognitive performance in 14 of 15 neuropsychological tests ( R coefficient = 0.6–0.8). The cognitive test scores were not independently associated with gender, admission GCS , associated trauma, and Marshal CT classification. Admission‐elevated blood glucose levels and the presence of sub‐arachnoid haemorrhage were independently associated with lower scores on R ey A uditory V erbal L earning retention and L ogical M emory‐I tests, respectively. Conclusions After correction for education and age distribution, the variables that are commonly associated with mortality or G lasgow O utcome S cale including admission pupils' examination, M arshal CT Classification, GCS , and serum glucose showed a limited predictive power for long‐term cognitive prognosis. Identification of clinical, radiological, and laboratory variables as well as new biomarkers independently associated with cognitive outcome remains an important challenge for further work involving severe TBI patients.
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