%0 Journal Article
%T Loss of consciousness and altered mental state as predictors of functional recovery within 6 months following mild traumatic brain injury
%J Journal of neuropsychiatry and clinical neurosciences
%D 2019
%A Roy, Durga
%A Peters, Matthew E.
%A Everett, Allen D.
%A Leoutsakos, Jeannie-Marie Sheppard
%A Yan, Haijuan
%A Rao, Vani
%A Bechtold, Kathleen T.
%A Sair, Haris I.
%A Van Meter, Tim
%A Falk, Hayley
%A Vassila, Alexandra
%A Hall, Anna
%A Ofoche, Uju
%A Akbari, Freshta
%A Lyketsos, Constantine
%A Korley, Frederick
%V ePub
%N ePub
%P ePub-ePub
%X OBJECTIVE: The authors tested the hypothesis that a combination of loss of consciousness (LOC) and altered mental state (AMS) predicts the highest risk of incomplete functional recovery within 6 months after mild traumatic brain injury (mTBI), compared with either condition alone, and that LOC alone is more strongly associated with incomplete recovery, compared with AMS alone. <br><br>METHODS: Data were analyzed from 407 patients with mTBI from <i>Head</i> injury <i>S</i>erum <i>M</i>arkers for <i>A</i>ssessing <i>R</i>esponse to <i>T</i>rauma (HeadSMART), a prospective cohort study of TBI patients presenting to two urban emergency departments. Four patient subgroups were constructed based on information documented at the time of injury: neither LOC nor AMS, LOC only, AMS only, and both. Logistic regression models assessed LOC and AMS as predictors of functional recovery at 1, 3, and 6 months. <br><br>RESULTS: A gradient of risk of incomplete functional recovery at 1, 3, and 6 months postinjury was noted, moving from neither LOC nor AMS, to LOC or AMS alone, to both. LOC was associated with incomplete functional recovery at 1 and 3 months (odds ratio=2.17, SE=0.46, p<0.001; and odds ratio=1.80, SE=0.40, p=0.008, respectively). AMS was associated with incomplete functional recovery at 1 month only (odds ratio=1.77, SE=0.37 p=0.007). No association was found between AMS and functional recovery in patients with no LOC. Neither LOC nor AMS was predictive of functional recovery at later times. <br><br>CONCLUSIONS: These findings highlight the need to include symptom-focused clinical variables that pertain to the injury itself when assessing who might be at highest risk of incomplete functional recovery post-mTBI.<p /> <p>Language: en</p>
%G en
%I American Psychiatric Publishing
%@ 0895-0172
%U http://dx.doi.org/10.1176/appi.neuropsych.18120379