title: The value of neurocognitive testing for acute outcomes after mild traumatic brain injury.
abstract: BACKGROUND
  Traditionally, neurocognitive testing is performed weeks to months after head injury and is mostly performed on patients who continue to have symptoms or difficulties. In this study, we sought to determine whether these tests, when administered acutely, could assist in predicting short-term outcomes after acute traumatic brain injury (TBI).
  
  
  METHODS
  This is an IRB-approved prospective study of adult patients who came to the emergency department of our Level-1 trauma center with TBI. Patients were enrolled prospectively after providing written informed consent and underwent three separate neurocognitive tests: the Galveston Orientation Amnesia Test (GOAT) the Rivermead Post-Concussion Survey Questionnaire (RPCSQ) and the Mini Mental Status Examination (MMSE).
  
  
  RESULTS
  A lower GOAT score was significantly associated with hospitalization (P = 0.0212) and the development of post-concussion syndrome (P = 0.0081) at late follow-up. A higher RPCSQ score was significantly associated with hospital admission (P = 0.0098), re-admission within 30 days of discharge (P = 0.0431) and evidence of post-concussion syndrome (PCS) at early follow-up (P = 0.0004). A higher MMSE score was significantly associated with not being admitted to the hospital (P = 0.0002) and not returning to the emergency department (ED) within 72 hours of discharge (P = 0.0078). Lower MMSE was also significantly associated with bleeding or a fracture on the brain CT (P = 0.0431).
  
  
  CONCLUSIONS
  While neurocognitive testing is not commonly performed in the ED in the setting of acute head injury, it is both feasible and appears to have value in predicting hospital admission and PCS. These data are especially important in terms of helping patients understand what to expect, thus, aiding in their recovery.
authors.affiliation: University of Central Florida College of Medicine, Orlando, Florida 32827 USA.
authors.forename: Latha
authors.initials: L
authors.lastname: Ganti
authors.affiliation: New York University, New York, NY USA.
authors.forename: Yasamin
authors.initials: Y
authors.lastname: Daneshvar
authors.affiliation: University of California, San Diego, California USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ayala
authors.affiliation: St Louis University, St Louis, MO USA.
authors.forename: Aakash N
authors.initials: AN
authors.lastname: Bodhit
authors.affiliation: University of Florida, Gainesville, FL USA.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Peters
keywords: Mild traumatic brain injury; Neurocognitive testing; Treatment outcome