title: Day of injury cognitive performance on the Military Acute Concussion Evaluation (MACE) by U.S. military service members in OEF/OIF.
abstract: OBJECTIVE
  The study investigated the clinical validity of the cognitive screening component of the Military Acute Concussion Evaluation (MACE) for the evaluation of acute mild traumatic brain injury (mTBI) in a military operational setting.
  
  
  METHODS
  This was a retrospective data study involving analysis of MACE data on Operation Enduring Freedom/Operation Iraqi Freedom deployed service members with mTBI. In total, 179 cases were included in analyses based on ICD-9 diagnostic codes and characteristics of mTBI, and availability of MACE data on day of injury. MACE data from the mTBI group was compared to a military sample without mTBI administered the MACE as part of a normative data project.
  
  
  RESULTS
  On day of injury, the mTBI group performed worse than controls on the MACE cognitive test (d = 0.90), with significant impairments in all cognitive domains assessed. MACE cognitive score was strongly associated with established indicators of acute injury severity. Lower MACE cognitive performance on day of injury was predictive of lengthier postinjury recovery time and time until return to duty after mTBI.
  
  
  CONCLUSIONS
  Findings from the current study support the use of the MACE as a valid screening tool to assess for cognitive dysfunction in military service members during the acute phase after mTBI.
authors.affiliation: Departments of Neurosurgery and Neurology, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI 53226.
authors.forename: Michael
authors.initials: M
authors.lastname: McCrea
authors.affiliation: Injury Prevention Research Center, University of North Carolina at Chapel Hill, 209 Fetzer Hall Box 8700, Chapel Hill, NC 27599.
authors.forename: Kevin
authors.initials: K
authors.lastname: Guskiewicz
authors.affiliation: Department of Veterans Affairs, Washington, DC, 8901 Rockville Pike, Bethesda, MD 20889.
authors.forename: Selina
authors.initials: S
authors.lastname: Doncevic
authors.affiliation: Departments of Neurosurgery and Neurology, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI 53226.
authors.forename: Katherine
authors.initials: K
authors.lastname: Helmick
authors.affiliation: Defense and Veterans Brain Injury Center, 1335 East-West Highway, Suite 6-100, Silver Spring, MD 20910.
authors.forename: Jan
authors.initials: J
authors.lastname: Kennedy
authors.affiliation: Defense and Veterans Brain Injury Center, 1335 East-West Highway, Suite 6-100, Silver Spring, MD 20910.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Boyd
authors.affiliation: Defense and Veterans Brain Injury Center, 1335 East-West Highway, Suite 6-100, Silver Spring, MD 20910.
authors.forename: Sarah
authors.initials: S
authors.lastname: Asmussen
authors.affiliation: Division of Biostatistics, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI 53226.
authors.forename: Kwang W
authors.initials: KW
authors.lastname: Ahn
authors.affiliation: Division of Biostatistics, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI 53226.
authors.forename: Yanzhi
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Psychology, Marquette University, 1250 W Wisconsin Avenue, Milwaukee, WI 53233.
authors.forename: James
authors.initials: J
authors.lastname: Hoelzle
authors.affiliation: Department of Neurology, University of Virginia, PO Box 800394, Charlottesville, VA 22908.
authors.forename: Michael
authors.initials: M
authors.lastname: Jaffee
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001924:Brain Concussion / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D015994:Incidence; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology