title: Introduction of the Abbreviated Westmead Post-Traumatic Amnesia Scale and Impact on Length of Stay.
abstract: OBJECTIVE
  Mild traumatic brain injury is a common presentation to Emergency Departments. Early identification of patients with cognitive deficits and provision of discharge advice are important. The Abbreviated Westmead Post-traumatic Amnesia Scale provides an early and efficient assessment of post-traumatic amnesia for patients with mild traumatic brain injuries, compared with the previously used assessment, the Modified Oxford Post-traumatic Scale.
  
  
  METHODS
  This retrospective cohort study reviewed 270 patients with mild traumatic brain injury assessed for post-traumatic amnesia over a 2-year period between February 2011 and February 2013. It identified those assessed with Abbreviated Westmead Post-traumatic Amnesia Scale versus Modified Oxford Post-traumatic Scale, the outcomes of these post-traumatic amnesia assessments, the hospital length of stay for patients, and their readmission rates.
  
  
  RESULTS
  The Abbreviated Westmead Post-traumatic Amnesia Scale was used in 91% of patient cases (and the Modified Oxford Post-traumatic Scale in 7%), and of those assessed with the Abbreviated Westmead Post-traumatic Amnesia Scale, 94% cleared post-traumatic amnesia testing within 4 h. Of those assessed with the Abbreviated Westmead Post-traumatic Amnesia Scale, 56% had a shorter length of stay than had they been assessed with the Modified Oxford Post-traumatic Scale, resulting in 295 bed-days saved. Verbal and written discharge advice was provided to those assessed for post-traumatic amnesia to assist their recovery. In all, 1% of patients were readmitted for monitoring of mild post-concussion symptoms.
  
  
  CONCLUSIONS
  The Abbreviated Westmead Post-traumatic Amnesia Scale provides an effective and timely assessment of post-traumatic amnesia for patients presenting to the Emergency Department with mild traumatic brain injury compared with the previously used assessment tool. It helps identify patients with cognitive impairment and the need for admission and further investigation, resulting in appropriate access to care. It also results in a decreased length of stay and decreased hospital admissions, with subsequent cost savings to the hospital.
authors.affiliation: 1 Occupational Therapy Department, Liverpool Hospital, Liverpool, NSW, Australia.
authors.forename: C E
authors.initials: CE
authors.lastname: Watson
authors.affiliation: 2 Trauma Department, Liverpool Hospital, Liverpool, NSW, Australia.|3 Trauma Unit, Department of Surgery, Academisch Medisch Centrum, Amsterdam, The Netherlands.
authors.forename: E A
authors.initials: EA
authors.lastname: Clous
authors.affiliation: 4 Neurosurgery Department, Liverpool Hospital, Liverpool, NSW, Australia.|5 Neurosurgery Department, Wollongong Hospital, Wollongong, NSW, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Jaeger
authors.affiliation: 2 Trauma Department, Liverpool Hospital, Liverpool, NSW, Australia.
authors.forename: S K
authors.initials: SK
authors.lastname: D'Amours
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000647:Amnesia / Q000175:diagnosis* / Q000209:etiology; D001924:Brain Concussion / Q000150:complications*; D002648:Child; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
keywords: A-WPTAS; Post-traumatic amnesia; length of stay; mild traumatic brain injury