Neuropsychological functioning in a national cohort of severe traumatic brain injury: demographic and acute injury-related predictors.
OBJECTIVE
To determine the rates of cognitive impairment 1 year after severe traumatic brain injury (TBI) and to examine the influence of demographic, injury severity, rehabilitation, and subacute functional outcomes on cognitive outcomes 1 year after severe TBI.


METHODS
National multicenter cohort study over 2 years.


METHODS
Patients (N = 105), aged 16 years or older, with Glasgow Coma Scale score of 3 to 8 and Galveston Orientation and Amnesia Test score of more than 75.


METHODS
Neuropsychological tests representing cognitive domains of Executive Functions, Processing Speed, and Memory. Injury severity included Rotterdam computed tomography score, Glasgow Coma Scale score, and posttraumatic amnesia (PTA) duration, together with length of rehabilitation and Glasgow Outcome Scale-Extended score.


RESULTS
In total, 67% of patients with severe TBI had cognitive impairment. Executive Functions, Processing Speed, and Memory were impaired in 41%, 58%, and 57% of patients, respectively. Using multiple regression analysis, Processing Speed was significantly related to PTA duration, Glasgow Outcome Scale-Extended score, and length of inpatient rehabilitation (R = 0.30); Memory was significantly related to Glasgow Outcome Scale-Extended score (R = 0.15); and Executive Functions to PTA duration (R = 0.10). Rotterdam computed tomography and Glasgow Coma Scale scores were not associated with cognitive functioning at 1 year postinjury.


CONCLUSIONS
Findings highlight cognitive consequences of severe TBI, with nearly two-thirds of patients showing cognitive impairments in at least 1 of 3 cognitive domains. Regarding injury severity predictors, only PTA duration was related to cognitive functioning.
Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway (Drs Sigurdardottir and Schanke); Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM) (Drs Sigurdardottir and Andelic), Faculty of Medicine (Dr Roe), and Department of Psychology, Faculty of Social Sciences (Dr Schanke), University of Oslo, Oslo, Norway; Division of Surgery and Clinical Neuroscience, Department of Physical Medicine and Rehabilitation (Drs Andelic, Roe, and Holthe), and Department of Neuroradiology (Dr Jerstad), Oslo University Hospital, Oslo, Norway; Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway (Dr Wehling); Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway (Dr Wehling); Department of Rehabilitation, University Hospital of North Norway, Tromso, Norway (Drs Anke and Aslaksen); Departments of Clinical Medicine (Dr Anke) and Psychology (Dr Aslaksen), Faculty of Health Sciences, University of Tromso, Tromso, Norway; Department of Physical Medicine and Rehabilitation, St Olavs Hospital, Trondheim, Norway (Dr Skandsen); and Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway (Dr Skandsen).
Solrun
S
Sigurdardottir
Nada
N
Andelic
Eike
E
Wehling
Cecilie
C
Roe
Audny
A
Anke
Toril
T
Skandsen
Oyvor O
OO
Holthe
Tone
T
Jerstad
Per M
PM
Aslaksen
Anne-Kristine
AK
Schanke
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009664:Norway; D020127:Recovery of Function; D012959:Socioeconomic Factors; D013997:Time Factors