Acute predictors of real-world outcomes following traumatic brain injury: a prospective study

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Abstract
To determine whether the recovery of acute attention and memory improves the prediction of real-world outcomes over that provided by standard demographic and injury-severity measures. Participants were recruited consecutively at the time of injury and followed prospectively at 1 (time 1, or T1) and 4 years (time 2, or T2). Measures of attention and memory and the Galveston Orientation and Amnesia Test (GOAT) were administered to 94 participants daily from the time of injury until the criterion was met. Sixty-three per cent returned at T1 and 53% returned at T2. Outcomes were psychosocial distress, return to work and/or school, and quality of life. Recovery of attention, memory and orientation did not significantly improve prediction of outcomes at T1, but did so at T2. At T2, recovery of free recall of three words over 24 h was a more sensitive predictor of psychosocial distress and return to productivity than the GOAT. Free recall of three words may be a useful acute clinical test to enhance prediction of long-term outcomes.

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