Classification schema of posttraumatic amnesia duration-based injury severity relative to 1-year outcome: analysis of individuals with moderate and severe traumatic brain injury.
OBJECTIVE
Early investigations classified traumatic brain injury (TBI) severity according to posttraumatic amnesia (PTA) duration, designating "greater than 7 days" as the most severe. PTA durations of more than 7 days are common in neurorehabilitation populations. Moreover, no study has derived a PTA severity schema anchored to late outcome. The purpose of this study was to develop a PTA severity classification schema.


METHODS
Prospective observational study.


METHODS
Rehabilitation hospital.


METHODS
Sample included TBI Model System participants (N=280) with known or imputed PTA duration during acute hospitalization and 1-year productivity status. Participants were primarily male (70%), median age of 27 years; and the most common mechanism of injury was motor vehicle collisions (79%). For study purposes, 4 injury severity groups were identified by observing differences in productivity associated with different PTA durations.


METHODS
None.


METHODS
Productivity status at 1 year postinjury.


RESULTS
Fisher exact test comparisons revealed significant differences among 3 of the groups. Most individuals with PTA fewer than 14 days had favorable 1-year outcome (68% productive), whereas worse outcomes were associated with PTA more than 28 days (18% productive).


CONCLUSIONS
If validated by other investigators, the proposed schema will be useful in determining prognosis for late functional status based on PTA duration.
Nakase-Richardson
Risa
R
James A. Haley Veterans Affairs Medical Center, Psychology Service, Tampa, Florida 33612, USA. Risa.Richardson@va.gov
Sepehri
Arash
A
Sherer
Mark
M
Yablon
Stuart A
SA
Evans
Clea
C
Mani
Tanja
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000647:Amnesia / Q000145:classification* / Q000209:etiology*; D001930:Brain Injuries / Q000145:classification* / Q000150:complications* / Q000534:rehabilitation; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012047:Rehabilitation Centers; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult