These results provide additional information to guide healthcare professionals in predicting overall outcome acutely post-TBI.

The objective of this study was to examine the performance of patients with traumatic brain injury (TBI) on the Montreal Cognitive Assessment (MoCA). The MoCA was administered to 214 patients with TBI during their acute care hospitalization in a Level 1 trauma center. The results showed that patients with severe TBI had lower scores on the MoCA compared with patients with mild and moderate TBI, F(2, 211) = 10.35, p = .0001. This difference was found for visuospatial/executive, attention, and orientation subtests (p < .05). Linear regression demonstrated that age, education, TBI severity, and the presence of neurological antecedents were the best predictors of cognitive impairments explaining 42% of the total variability of the MoCA. This information can enable clinicians to predict early cognitive impairments and plan cognitive rehabilitation earlier in the recovery process.

These results indicated that the MoCA and the MMSE function as similar predictors of the DRS at discharge.

Patients with sTBI 2 to 5 years postinjury showed relatively good physical and functional outcome but poorer cognitive and emotional outcome.

This study looked at performance on the conversational discourse checklist of the Protocole Montréal d'évaluation de la communication (D-MEC) in 195 adults with TBI of all severity hospitalized in a Level 1 Trauma Centre. To explore validity, results were compared to findings on tests of memory, mental flexibility, confrontation naming, semantic and letter category naming, verbal reasoning, and to scores on the Montreal Cognitive Assessment. The relationship to outcome as measured with the Disability Rating Scale (DRS), the Extended Glasgow Outcome Scale (GOS-E), length of stay, and discharge destinations was also determined. Patients with severe TBI performed significantly worse than mild and moderate groups (χ(2)(KW2df) = 24.435, p = .0001). The total D-MEC score correlated significantly with all cognitive and language measures (p < .05). It also had a significant moderate correlation with the DRS total score (r = -.6090, p < .0001) and the GOS-E score (r = .539, p < .0001), indicating that better performance on conversational discourse was associated with a lower disability rating and better global outcome. Finally, the total D-MEC score was significantly different between the discharge destination groups (F(3,90) = 20.19, p < .0001). Thus, early identification of conversational discourse impairment in acute care post-TBI was possible with the D-MEC and could allow for early intervention in speech-language pathology.

These findings add information regarding acute olfactory status following TBI and provide evidence on the importance of assessing olfaction very early post-TBI in order to plan intervention and determine what accident prevention advice will be required for home or work re-integration.

No abstract

The aim of this study was to compare the performances of patients with mild, moderate, and severe traumatic brain injury (TBI) on the Clock Drawing Test (CDT), the Mini-Mental State Examination (MMSE), and neuropsychological measures as well as to correlate these measures with outcome assessed by the Extended Glasgow Outcome Score. This study was conducted in an acute care early rehabilitation setting on 102 patients with mild, 30 with moderate, and 30 with severe TBI. Patients with moderate and severe TBI showed more impairment on the CDT compared with those with mild TBI. Similar results were obtained for the MMSE, F ((2,159df)) = 3.789, p = .025. Finally, a receiver-operating characteristic analysis showed that the CDT and the Trail-Making Test-Part B (TMT-B) in combination have the potential for prediction of outcome in a TBI population. In conclusion, this combination of the CDT and the TMT-B seems to be useful for early assessment of TBI patients.