A multicentre study on the clinical utility of posttraumatic amnesia duration in predicting global outcome after moderate-severe traumatic brain injury

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Study assessed the relationship between post-traumatic amnesia (PTA) duration and probability thresholds for Glasgow Outcome Scale (GOS) levels. GOS is an ordinal scale designed to measure global outcome after traumatic brain injury (TBI)with categories of: Death, Persistent Vegetative State, Severe Disability, Moderate Disability, and Good Recovery. Data were prospectively collected from a consecutive sample of 1,332 rehabilitation patients enrolled in TBI Model Systems medical centers. Participants had documented finite PTA duration greater than 24 hours, and 1-year and 2-year GOS. Analysis of the data showed an overall improvement during the second year, with proportionally more Good Recovery (44 percent versus 39 percent) and less Severe Disability (19 percent versus 23 percent) at year 2 than at year 1. Multinomial logistic regression models confirmed that PTA was a significant predictor of GOS levels at year 1 and year 2. Longer PTA resulted in an incremental decline in probability of Good Recovery and a corresponding increase in probability of Severe Disability. When PTA ended within 4 weeks, Severe Disability was unlikely (less than a 15 percent chance) at year 1, and Good Recovery was the most likely GOS at year 2. When PTA lasted beyond 8 weeks, Good Recovery was highly unlikely (less than a 10 percent chance) at year 1, and Severe Disability was equal to or more likely than Moderate Disability at year 2.

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