Journal:Journal of Neurosurgical Psychiatry
Year, Volume, Issue, Page(s):11, 82, 5, 494-499
Study compared the predictive ability of a new traumatic brain injury (TBI) severity classification model of post-traumatic amnesia (PTA) duration anchored to late productivity outcome (Mississippi intervals), with that of the criterion standard Russell intervals. The study population included 3,846 TBI Model System participants with known or imputed PTA duration during acute hospitalization. Productivity status at 1-year postinjury was used to compare predicted outcomes using the Mississippi and Russell classification intervals. Logistic regression model-generated curves were used to compare the performance of the classification intervals by assessing the area under the curve (AUC); the highest AUC represented the best-performing model. All severity variables evaluated were individually associated with return to productivity at 1 year (RTP1). Age was significantly associated with RTP1; however, younger patients had a different association than older patients. After adjustment for individually significant variables, the odds of RTP1 decrease by 14 percent with every additional week of PTA duration. The AUC for the Russell intervals was significantly smaller than the Mississippi intervals. The results suggest that the Mississippi PTA interval classification model is a valid predictor of productivity at 1 year postinjury and provides a more sensitive categorization of PTA values than the Russell intervals.