title: Identifying posttraumatic amnesia in individuals with a Glasgow Coma Scale of 15 after mild traumatic brain injury.
abstract: OBJECTIVE
  To examine the utility of the Abbreviated Westmead Post-traumatic Amnesia Scale, which includes the Glasgow Coma Scale (GCS) and 3 picture cards used to measure amnesia, in identifying the presence or absence of posttraumatic amnesia in individuals with mild traumatic brain injury (mTBI).
  
  
  METHODS
  Prospective study using data from the Abbreviated Westmead Post-traumatic Amnesia Scale.
  
  
  METHODS
  Trauma hospital.
  
  
  METHODS
  Individuals with possible mTBI who presented between April and September 2011 (N=252; age range, 18-65y; mean age, 37.4±13.9y; 77% men).
  
  
  METHODS
  Administration of the Abbreviated Westmead Post-traumatic Amnesia Scale.
  
  
  METHODS
  GCS and Abbreviated Westmead Post-traumatic Amnesia Scale pass/fail rates.
  
  
  RESULTS
  Of the individuals, 169 (mean age, 35.1±13.6y; 77% men) received the scale. A pass/fail performance was achieved a median 121 minutes (interquartile range, 89-205min) after triage. Of the 45 who failed, 31 (69%) had a GCS score of 15. The likelihood of failing was associated with being older (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.06; P<.05), having consumed alcohol (OR, 3.09; 95% CI, 1.42-6.74; P<.01), and the scale being administered closer to the time of the injury (OR, 0.99; 95% CI, 0.99-1.00; P<.05). Nineteen (42%) of those who failed had consumed alcohol, 11 had a GCS score of 15, and 8 had a GCS score of 14.
  
  
  CONCLUSIONS
  A GCS score of 15 does not always signify return to normative cognitive function. Individuals with a GCS score of 15 who are acutely cognitively impaired are at risk of not being accurately identified. The addition of an amnesia score to the GCS in the Abbreviated Westmead Post-traumatic Amnesia Scale will assist in making a diagnosis of mTBI.
authors.affiliation: Department of Psychology, Macquarie University, North Ryde, NSW, Australia; Department of Rehabilitation Medicine, Westmead Hospital, Westmead, NSW, Australia. Electronic address: sue.meares@mq.edu.au.
authors.forename: Susanne
authors.initials: S
authors.lastname: Meares
authors.affiliation: Department of Psychology, Macquarie University, North Ryde, NSW, Australia.
authors.forename: E Arthur
authors.initials: EA
authors.lastname: Shores
authors.affiliation: Department of Psychology, Macquarie University, North Ryde, NSW, Australia; Department of Emergency Services, Westmead Hospital, Westmead, NSW, Australia.
authors.forename: Tracy
authors.initials: T
authors.lastname: Smyth
authors.affiliation: Department of Psychology, Macquarie University, North Ryde, NSW, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Batchelor
authors.affiliation: Department of Emergency Services, Westmead Hospital, Westmead, NSW, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Murphy
authors.affiliation: Department of Emergency Services, Westmead Hospital, Westmead, NSW, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Vukasovic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D000647:Amnesia / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D001930:Brain Injuries / Q000150:complications*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D013997:Time Factors; D014193:Trauma Centers; D055815:Young Adult
keywords: Amnesia, anterograde; Brain injuries; Rehabilitation