Using early neuropsychologic testing to predict long-term productivity outcome from traumatic brain injury.
OBJECTIVE
To evaluate whether early neuropsychologic testing is useful in predicting long-term productivity outcome after traumatic brain injury (TBI).


METHODS
Validation cohort prediction study.


METHODS
Four inpatient brain injury rehabilitation programs participating in the Traumatic Brain Injury Model Systems project.


METHODS
A total of 293 adults with nonpenetrating TBI.


METHODS
Fifteen neuropsychologic tests were administered to patients who emerged from posttraumatic amnesia before rehabilitation discharge. Test scores were classified in the normal range or impaired range, using objective criteria. Outcome was defined as productive if the patient was competitively employed or enrolled full time in regular education.


RESULTS
Productivity at follow-up was predicted by completion of at least 1 neuropsychologic test before discharge, by an injury-test interval of less than 2 months, and by normal range scores on 10 of the 15 neuropsychologic tests. Normal range scores on these tests increased the probability of a productive outcome by 40% to 130%.


CONCLUSIONS
Neuropsychologic testing can help predict long-term productivity even when performed before discharge from inpatient rehabilitation and at variable injury-test intervals. Early testing should be interpreted in relation to injury-test interval. Because tests of multiple neuropsychologic domains predicted outcome, comprehensive evaluations might be more useful in predicting outcome.
Boake
C
C
Institute for Rehabilitation and Research, Houston, TX 77030-3405, USA. Corwin.Boake@uth.tmc.edu
Millis
S R
SR
High
W M
WM
Delmonico
R L
RL
Kreutzer
J S
JS
Rosenthal
M
M
Sherer
M
M
Ivanhoe
C B
CB
D000328:Adult; D001930:Brain Injuries / Q000175:diagnosis* / Q000534:rehabilitation*; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012306:Risk; D014481:United States