Traditional predictors of long-term outcome after a severe traumatic brain injury (TBI) include the motor score from the Glasgow Coma Scale, papillary reaction, and age. However, these predictors are more reliable for predicting mortality or severe disability. A recent study sought to determine the best predictor of cognitive functioning after severe TBI.
The researchers compared the outcomes of severe TBI patients who had more than 12 hours of intensive care treatment. Using a battery of neuropsychological assessments and the Glasgow Outcome Scale (GOS), they found that a GOS score at the time of discharge from the hospital was significantly less likely to long-term outcome that the GOS score at the time of discharge from rehabilitation. In addition, they found that patients who were under the age of 40 were more likely to have a favorable long-term outcome.
The prediction of long-term outcome is an important element for determining how much support should be provided, and for how long. The study found that the GOS score at rehabilitation discharge was a good predictor for long-term cognitive function after severe TBI.
Gautschi OP, Huser MC, Smoll NR, et al. Long-term neurological and neuropsychological outcome in patients with severe traumatic brain injury. Clinical Neurology and Neurosurgery. (December 2013).