Optimizing and simplifying post-traumatic amnesia testing after moderate-severe traumatic brain injury despite common confounders in routine practice
| Autor: | L. delle Baite, Maria Hennessy, Laurence A.G. Marshman, J. McLellan |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Traumatic brain injury Amnesia Routine practice Memory and Learning Tests 03 medical and health sciences Galveston Orientation and Amnesia Test 0302 clinical medicine Physiology (medical) Internal medicine Outcome indicator Brain Injuries Traumatic medicine Humans Elective surgery Post-traumatic amnesia business.industry Confounding General Medicine Middle Aged medicine.disease Analgesics Opioid Neurology 030220 oncology & carcinogenesis Surgery Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 81 |
| ISSN: | 1532-2653 |
| Popis: | The duration of post-traumatic amnesia (PTA) following traumatic brain injury (TBI) is a key diagnostic and outcome indicator. However, concerningly, different PTA paradigms record different PTA durations: some over-estimate, others under-estimate, PTA. Thus, a compromise is implied. The potential effect of in-hospital confounders including opioids is unknown. Three clinical groups were prospectively recruited. Group-1: in-patients with moderate-severe-TBI (MS-TBI), considered likely ‘in-PTA’. Group-2: patients rehabilitating after recent MS-TBI, considered ‘out-of-PTA’. Group-3: orthopaedic in-patients without TBI undergoing elective surgery. Only Groups 1&3 were taking opioids. All were administered the Westmead Post-traumatic Amnesia Scale (WPTAS) and the Galveston Orientation and Amnesia Test (GOAT). Results were obtained in n = 56 (Group-1:n = 18, Group-2:n = 13 and Group-3:n = 25). On WPTAS, Groups 1&3 scored similarly, but significantly lower than, Group-2 (χ2 = 8.2, P = 0.017). Contrariwise, on GOAT, Group-1 scored significantly lower than Groups 2&3 (χ2 = 23.99, P Conclusions Confounders including opioids likely affected WPTAS overall, but not GOAT specificity. A merger, whereby WPTAS sensitivity augmented GOAT specificity, was therefore sought. Favourable items from WPTAS (4/12) and GOAT (3/10) together optimized, and yet simplified, PTA testing; despite prevalent clinical confounders. Less, not more, ‘PTA’ items would benefit both patients and staff alike. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect